School of Health Sciences, University of Southampton, Southampton, England.
NIHR Applied Research Collaboration Wessex, School of Health Sciences, University of Southampton, Southampton, England.
PLoS One. 2022 Aug 2;17(8):e0266638. doi: 10.1371/journal.pone.0266638. eCollection 2022.
Women have reported dissatisfaction with care received on postnatal wards and this area has been highlighted for improvement. Studies have shown an association between midwifery staffing levels and postnatal care experiences, but so far, the influence of registered and support staff deployed in postnatal wards has not been studied. This work is timely as the number of support workers has increased in the workforce and there has been little research on skill mix to date.
Cross sectional secondary analysis including 13,264 women from 123 postnatal wards within 93 hospital Trusts. Staffing was measured in each organisation as Full Time Equivalent staff employed per 100 births, and on postnatal wards, using Hours Per Patient Day. Women's experiences were assessed using four items from the 2019 national maternity survey. Multilevel logistic regression models were used to examine relationships and adjust for maternal age, parity, ethnicity, type of birth, and medical staff.
Trusts with higher levels of midwifery staffing had higher rates of women reporting positive experiences of postnatal care. However, looking at staffing on postnatal wards, there was no evidence of an association between registered nurses and midwives hours per patient day and patient experience. Wards with higher levels of support worker staffing were associated with higher rates of women reporting they had help when they needed it and were treated with kindness and understanding.
The relationship between reported registered staffing levels on postnatal wards and women's experience is uncertain. Further work should be carried out to examine why relationships observed using whole Trust staffing were not replicated closer to the patient, with reported postnatal ward staffing. It is possible that recorded staffing levels on postnatal wards do not actually reflect staff deployment if midwives are floated to cover delivery units. This study highlights the potential contribution of support workers in providing quality care on postnatal wards.
女性对产后病房的护理满意度不高，这一领域亟待改进。研究表明，助产士人员配备水平与产后护理体验之间存在关联，但迄今为止，尚未研究产后病房中注册护士和支持人员的部署情况。由于支持人员在劳动力中的数量增加，而迄今为止对技能组合的研究甚少，因此这项工作具有及时性。
包括来自 93 家医院信托基金的 123 个产后病房的 13264 名女性的横断面二次分析。每个组织的人员配备都以每 100 名分娩的全职等效员工来衡量，在产后病房则以每位患者每天的工作时间来衡量。使用 2019 年国家产妇调查的四个项目评估女性的体验。使用多水平逻辑回归模型来检查关系，并调整产妇年龄、生育次数、种族、分娩类型和医务人员等因素。
助产士人员配备水平较高的信托基金中，报告产后护理体验积极的女性比例较高。然而，从产后病房的人员配备情况来看，注册护士和助产士每天每位患者的工作时间与患者体验之间没有证据表明存在关联。支持人员配备水平较高的病房与报告需要帮助时得到帮助、并得到友善和理解的女性比例较高有关。
产后病房报告的注册人员配备水平与女性体验之间的关系不确定。应进一步开展工作，以检查为什么使用整个信托基金人员配备情况观察到的关系在更接近患者的情况下没有被复制，即报告的产后病房人员配备情况。如果助产士被调去覆盖分娩单位，那么记录在案的产后病房人员配备水平可能实际上并不能反映人员部署情况。这项研究强调了支持人员在提供产后病房优质护理方面的潜在贡献。
