Rebecca R S Clark, Morgan E Peele, Aleigha Mason, Eileen T Lake
{"title":"在护士工作环境不同的产科病房中，护士人员配备对错过母乳喂养支持的影响。","authors":"Rebecca R S Clark, Morgan E Peele, Aleigha Mason, Eileen T Lake","doi":"10.1097/JPN.0000000000000824","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To examine the effect of nurse staffing in varying work environments on missed breastfeeding teaching and support in inpatient maternity units in the United States.</p><p><strong>Background: </strong>Breast milk is the optimal food for newborns. Teaching and supporting women in breastfeeding are primarily a nurse's responsibility. Better maternity nurse staffing (fewer patients per nurse) is associated with less missed breastfeeding teaching and support and increased rates of breastfeeding. We examined the extent to which the nursing work environment, staffing, and nurse education were associated with missed breastfeeding care and how the work environment and staffing interacted to impact missed breastfeeding care.</p><p><strong>Methods: </strong>In this cross-sectional study using the 2015 National Database of Nursing Quality Indicator survey, maternity nurses in hospitals in 48 states and the District of Columbia responded about their workplace and breastfeeding care. Clustered logistic regression models with interactions were used to estimate the effects of the nursing work environment and staffing on missed breastfeeding care.</p><p><strong>Results: </strong>There were 19 486 registered nurses in 444 hospitals. Nearly 3 in 10 (28.2%) nurses reported missing breastfeeding care. In adjusted models, an additional patient per nurse was associated with a 39% increased odds of missed breastfeeding care. Furthermore, 1 standard deviation decrease in the work environment was associated with a 65% increased odds of missed breastfeeding care. In an interaction model, staffing only had a significant impact on missed breastfeeding care in poor work environments.</p><p><strong>Conclusions: </strong>We found that the work environment is more fundamental than staffing for ensuring that not only breastfeeding care is not missed but also breastfeeding care is sensitive to nurse staffing. Improvements to the work environment support the provision of breastfeeding care.</p><p><strong>Implications for research and practice: </strong>Both nurse staffing and the work environment are important for improving breastfeeding rates, but the work environment is foundational.</p>","PeriodicalId":54773,"journal":{"name":"Journal of Perinatal & Neonatal Nursing","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effects of Nurse Staffing on Missed Breastfeeding Support in Maternity Units With Different Nurse Work Environments.\",\"authors\":\"Rebecca R S Clark, Morgan E Peele, Aleigha Mason, Eileen T Lake\",\"doi\":\"10.1097/JPN.0000000000000824\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To examine the effect of nurse staffing in varying work environments on missed breastfeeding teaching and support in inpatient maternity units in the United States.</p><p><strong>Background: </strong>Breast milk is the optimal food for newborns. Teaching and supporting women in breastfeeding are primarily a nurse's responsibility. Better maternity nurse staffing (fewer patients per nurse) is associated with less missed breastfeeding teaching and support and increased rates of breastfeeding. We examined the extent to which the nursing work environment, staffing, and nurse education were associated with missed breastfeeding care and how the work environment and staffing interacted to impact missed breastfeeding care.</p><p><strong>Methods: </strong>In this cross-sectional study using the 2015 National Database of Nursing Quality Indicator survey, maternity nurses in hospitals in 48 states and the District of Columbia responded about their workplace and breastfeeding care. Clustered logistic regression models with interactions were used to estimate the effects of the nursing work environment and staffing on missed breastfeeding care.</p><p><strong>Results: </strong>There were 19 486 registered nurses in 444 hospitals. Nearly 3 in 10 (28.2%) nurses reported missing breastfeeding care. In adjusted models, an additional patient per nurse was associated with a 39% increased odds of missed breastfeeding care. Furthermore, 1 standard deviation decrease in the work environment was associated with a 65% increased odds of missed breastfeeding care. In an interaction model, staffing only had a significant impact on missed breastfeeding care in poor work environments.</p><p><strong>Conclusions: </strong>We found that the work environment is more fundamental than staffing for ensuring that not only breastfeeding care is not missed but also breastfeeding care is sensitive to nurse staffing. Improvements to the work environment support the provision of breastfeeding care.</p><p><strong>Implications for research and practice: </strong>Both nurse staffing and the work environment are important for improving breastfeeding rates, but the work environment is foundational.</p>\",\"PeriodicalId\":54773,\"journal\":{\"name\":\"Journal of Perinatal & Neonatal Nursing\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Perinatal & Neonatal Nursing\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/JPN.0000000000000824\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/5/13 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Perinatal & Neonatal Nursing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/JPN.0000000000000824","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/5/13 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"NURSING","Score":null,"Total":0}
Effects of Nurse Staffing on Missed Breastfeeding Support in Maternity Units With Different Nurse Work Environments.
Purpose: To examine the effect of nurse staffing in varying work environments on missed breastfeeding teaching and support in inpatient maternity units in the United States.
Background: Breast milk is the optimal food for newborns. Teaching and supporting women in breastfeeding are primarily a nurse's responsibility. Better maternity nurse staffing (fewer patients per nurse) is associated with less missed breastfeeding teaching and support and increased rates of breastfeeding. We examined the extent to which the nursing work environment, staffing, and nurse education were associated with missed breastfeeding care and how the work environment and staffing interacted to impact missed breastfeeding care.
Methods: In this cross-sectional study using the 2015 National Database of Nursing Quality Indicator survey, maternity nurses in hospitals in 48 states and the District of Columbia responded about their workplace and breastfeeding care. Clustered logistic regression models with interactions were used to estimate the effects of the nursing work environment and staffing on missed breastfeeding care.
Results: There were 19 486 registered nurses in 444 hospitals. Nearly 3 in 10 (28.2%) nurses reported missing breastfeeding care. In adjusted models, an additional patient per nurse was associated with a 39% increased odds of missed breastfeeding care. Furthermore, 1 standard deviation decrease in the work environment was associated with a 65% increased odds of missed breastfeeding care. In an interaction model, staffing only had a significant impact on missed breastfeeding care in poor work environments.
Conclusions: We found that the work environment is more fundamental than staffing for ensuring that not only breastfeeding care is not missed but also breastfeeding care is sensitive to nurse staffing. Improvements to the work environment support the provision of breastfeeding care.
Implications for research and practice: Both nurse staffing and the work environment are important for improving breastfeeding rates, but the work environment is foundational.
期刊介绍：
The Journal of Perinatal and Neonatal Nursing (JPNN) strives to advance the practice of evidence-based perinatal and neonatal nursing through peer-reviewed articles in a topic-oriented format. Each issue features scholarly manuscripts, continuing education options, and columns on expert opinions, legal and risk management, and education resources. The perinatal focus of JPNN centers around labor and delivery and intrapartum services specifically and overall perinatal services broadly. The neonatal focus emphasizes neonatal intensive care and includes the spectrum of neonatal and infant care outcomes. Featured articles for JPNN include evidence-based reviews, innovative clinical programs and projects, clinical updates and education and research-related articles appropriate for registered and advanced practice nurses.
The primary objective of The Journal of Perinatal & Neonatal Nursing is to provide practicing nurses with useful information on perinatal and neonatal nursing. Each issue is PEER REVIEWED and will feature one topic, to be covered in depth. JPNN is a refereed journal. All manuscripts submitted for publication are peer reviewed by a minimum of three members of the editorial board. Manuscripts are evaluated on the basis of accuracy and relevance of content, fit with the journal purpose and upcoming issue topics, and writing style. Both clinical and research manuscripts applicable to perinatal and neonatal care are welcomed.
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