Mason Aleigha, Lake Eileen T, Clark Rebecca R S
Author Affiliations: Center for Health Outcome & Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania (Ms Mason); Center for Health Outcomes and Policy Research Editor, Research in Nursing & Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania (Dr Lake); and Center for Health Outcomes and Policy Research Nurse Scientist, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania (Dr Clark).
J Perinat Neonatal Nurs. 2024 Sep 23. doi: 10.1097/JPN.0000000000000859.
To summarize how nursing resources and missed nursing care are associated with hospital breastfeeding outcomes, including human milk provision.
Nurses are the primary providers of breastfeeding support in the hospital. Nursing resources, eg, staffing and the work environment, enable nurses to carry out their work successfully. If resources are constrained, nurses may miss providing breastfeeding support. There is a gap in the literature about the relationships among nursing resources, missed nursing care, and breastfeeding outcomes.
The Cumulative Index to Nursing and Allied Health Literature and PubMed were searched with keywords such as: "nurse staffing," "nurse work environment," "missed nursing care," "breastfeeding," "human milk," and "lactation." We included peer-reviewed studies of US samples in English published between 2014 and 2022.
Of 312 references, 8 met inclusion criteria: 5 quantitative and 3 qualitative. Better nurse staffing and breastfeeding support were associated with improved breastfeeding outcomes in the qualitative and quantitative literature. Missed care partially mediated the relationship between staffing and exclusive breast milk feeding rates. Better nurse work environments were associated with increased breastfeeding support and provision of human milk.
Empirical evidence supports an association between the nurse work environment, nurse staffing, breastfeeding support, and outcomes. Implications for practice and research: Poor staffing may be associated with decreased breastfeeding support and outcomes. Hospital administrators and nurse managers may consider improving nurse staffing and the work environment to improve breastfeeding outcomes. Future research should simultaneously examine staffing and the work environment and address breastfeeding outcome disparities.
总结护理资源和护理缺失与医院母乳喂养结局（包括母乳提供）之间的关联。
护士是医院母乳喂养支持的主要提供者。护理资源，如人员配备和工作环境，使护士能够成功开展工作。如果资源受限，护士可能会错过提供母乳喂养支持。关于护理资源、护理缺失和母乳喂养结局之间的关系，文献中存在空白。
使用“护士人员配备”“护士工作环境”“护理缺失”“母乳喂养”“母乳”和“哺乳”等关键词，检索护理及相关健康文献累积索引和医学期刊数据库。我们纳入了2014年至2022年间发表的、以美国样本为研究对象的英文同行评审研究。
在312篇参考文献中，8篇符合纳入标准：5篇定量研究和3篇定性研究。定性和定量文献均表明，更好的护士人员配备和母乳喂养支持与改善母乳喂养结局相关。护理缺失部分介导了人员配备与纯母乳喂养率之间的关系。更好的护士工作环境与增加母乳喂养支持和母乳提供相关。
实证证据支持护士工作环境、护士人员配备、母乳喂养支持和结局之间存在关联。对实践和研究的启示：人员配备不足可能与母乳喂养支持和结局下降有关。医院管理人员和护士经理可考虑改善护士人员配备和工作环境，以改善母乳喂养结局。未来的研究应同时考察人员配备和工作环境，并解决母乳喂养结局的差异问题。
