Are we withholding quality nursing care due to staffing ratios? A cross sectional study on perinatal units.

Date of Award/Publication


Document Type


Degree Name

M.S. in Advanced Practice Nursing

First Supervisor

Dr. Nancy Wilk

Second Supervisor

Dr. Heather McGrane-Minton


Objective: To examine the correlation of nurse staffing, patient outcomes, and missed nursing care on a perinatal unit

Design: Cross-sectional online survey, distributed via Facebook.

Setting: Perinatal units that currently follow The 2010 AWHONN Staffing Guidelines.

Participants: Perinatal Registered Nurses who have direct patient care during the majority of their work shifts.

Methods: Analysis of the response to a cross-sectional online survey. Data was measured using SPSS. An independent t-test and ANOVA were conducted.

Results: Nurses caring for fewer than four couplets reported a lower ability to offer emotional/psychosocial support to a patient even though it was felt necessary compared to nurses caring for greater than four couplets (t(36)= -2.19, p= 0.04). Nurses who felt comfortable refusing an unsafe assignment reported a lower inability to fully prepare patients and their families on discharge as compared to nurses who did not feel comfortable refusing an unsafe assignment and those who were unsure in their comfort to refuse an unsafe environment (F(2,35) = 3.92, p = 0.029)

Conclusion: The findings of this study provides insights on risk factors that increase nursing workload conditions, resulting in basic nursing care being missed. By knowing the risks for increasing nurse workloads and higher acuity assignments one can propose interventions to prevent missed nursing care leading to higher quality care being provided, which can result in better patient outcomes.


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