Three Missed Critical Nursing Care Processes on Labor and Delivery Units During the COVID-19 Pandemic.
Joyce K Edmonds, Erin K George, Stacey E Iobst and 1 others
PMID 37178712WHAT IT FOUND
One third of labor and delivery nurses reported missing critical care tasks like responding to abnormal fetal heart rates or maternal complications.
Nurses who felt they had less time at the bedside were significantly more likely to miss these safety checks. Adequate staffing was associated with fewer missed tasks.
Key findings
01One third of respondents reported that they or nursing staff on their units missed at least one of three critical nursing care processes in the past month.
02Respondents who agreed that nurses were spending less time at the bedside had statistically significant greater odds of missing any critical aspects of care compared to respondents who disagreed.
03Respondents who reported that unit staffing was adequate for greater than or equal to 75% of the time had lower odds of missing any critical aspects of care than those who reported inadequate staffing.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used a convenience sample and self-reported data, which may introduce selection bias and social desirability bias, potentially underestimating the true rate of missed care. The cross-sectional design prevents establishing causality; it shows an association between perceptions of time/staffing and missed care, but does not prove one causes the other. The measure for 'nursing time at the bedside' was a single researcher-developed item that was not psychometrically validated. Data were collected during a specific peak of the pandemic, which may limit generalizability to non-pandemic periods or other healthcare settings.
Declared interests
The authors received support from the Institute for Perinatal Quality Improvement, which provided recruitment materials and offered a free continuing education module as an incentive for participation. The authors declared no other conflicts of interest.
The easy way to misread this
Do not interpret these findings as proof that increasing staffing levels directly causes a reduction in missed care. The study is cross-sectional and relies on nurses' perceptions of their own time and staffing adequacy, not objective measures. It identifies an association, but other unmeasured factors could influence both the perception of workload and the reporting of missed care.