Linking the work environment to missed nursing care in labour and delivery

Abstract

Labour and delivery (L&D) registered nurses (RNs) are the frontline providers during labour. They provide continuous bedside care that is instrumental to labour progression and critical to achieving optimal birth outcomes (Association of Women's Health Obstetric & Neonatal Nurses, 2018). Childbirth is the most common reason for hospitalization, with 4 million women giving birth each year, comprising 1 in 9 hospitalizations (McDermott, Elixhauser, & Sun, 2017).

Burnout, job dissatisfaction and missed care among maternity nurses

“…The study of missed care among labour and delivery nurses used data from the 2006 RN4CAST survey and found a missed care prevalence of 49.2%, similar to the 56.4% prevalence reported in this paper (Lake et al., 2019). As with the findings reported here, comforting and talking with patients was the most commonly reported missed care tasks (Lake et al., 2019). Corresponding with these findings, a qualitative study of 71 labour and delivery nurses reported that support and education were aspects of care likely to be missed (Simpson & Lyndon, 2017).…”

“…Missed care in maternity care, and factors effecting missed care, is beginning to receive attention as a means by which the quality and safety of maternity care may be improved, thus improving outcomes. A recent quantitative study based on 2006 data found an association between the clinical work environment and missed care among labour and delivery nurses (Lake, French, O’Rourke, Sanders, & Srinivas, 2019). Meanwhile, a qualitative study conducted with nurses noted a number of potential adverse maternal and infant outcomes associated with missed care (Simpson & Lyndon, 2017).…”

Nurses’ Perceptions of Professional Practice Environment and Its Relation to Missed Nursing Care and Nurse Satisfaction

“…In a better practice environment, nurses miss approximately one fewer necessary care activity [37]. A recent study by Lake, Riman, and Sloane [12] indicated a reduction in missed care in hospitals with better work environments or improved nurse staffing, with the effect of changes in the work environment being greater than that of nurse staffing on missed care. The conclusion of a systematic review by Zhao et al [1] also confirmed the negative correlation between the professional environment and missed care [1].…”

“…Professional practice environment is, in the scientific literature, also known as work environment, working conditions, and job characteristics [11]. The professional practice environment of nurses is one of the predictors of missed nursing care [3,12]. The work conditions can be grouped in different concepts such as nurse participation, supportive managers, staffing, patient-centered climate, autonomy, philosophy focusing on quality of care, collaborative relationships with physicians, collaborative relationships with peers, decentralization, and busyness [11].…”

Relationship between nurse practice environment and work outcomes: A survey study in the Philippines

“…Insufficient resources and staffing in the work environment lead to poor work outcomes such as increased burnout and job dissatisfaction (Al Sabei et al, 2020; Liu et al, 2012). A good nurse work environment characterized by adequate resources and supportive management has been strongly associated with lower levels of adverse event and missed care reporting, higher nurse‐reported safety levels and higher nurse‐assessed quality of care (Hinno, Partanen, & Vehviläinen‐Julkunen, 2012; Kirwan, Matthews, & Scott, 2013; Lake, French, O'Rourke, Sanders, & Srinivas, 2019). In a study involving army hospitals, a positive nurse–physician relationship and adequate nursing staff and hospital resources contributed significantly to lower rates of falls, reduced medication errors and positive patient experiences (Swiger et al, 2018).…”