ABSTRACT
This document has been archived because it contains outdated information. It should not be consulted for clinical use, but for historical research only. Please visit the journal website for the most recent guidelines.
Ce document a été archivé, car il contient des informations périmées. Il ne devrait pas être consulté pour un usage clinique, mais uniquement pour des recherches historiques. Veuillez consulter le site web du journal pour les directives les plus récentes.
Subject(s)
Congenital Abnormalities/diagnosis , Fetal Diseases/diagnosis , Fetus/anatomy & histology , Magnetic Resonance Imaging , Breast Feeding , Contrast Media , Female , Gadolinium DTPA , Humans , Infant, Newborn , Patient Safety , Placenta Accreta/diagnosis , Pregnancy , Pregnancy Complications/diagnosis , Pregnancy TrimestersSubject(s)
Delivery Rooms , Inpatients/classification , Nurse Midwives/supply & distribution , Nursing Staff, Hospital/supply & distribution , Obstetric Nursing , Personnel Staffing and Scheduling/standards , Adult , Delivery Rooms/organization & administration , Efficiency, Organizational , Female , Guidelines as Topic , Humans , Infant, Newborn , Inpatients/statistics & numerical data , Manitoba , Nurse Midwives/organization & administration , Nursing Administration Research , Nursing Records , Nursing Staff, Hospital/organization & administration , Pregnancy , Pregnancy Complications/classification , Pregnancy Complications/nursing , Pregnancy, High-Risk , Triage , WorkforceABSTRACT
INTRODUCTION: In its guideline on intrapartum fetal surveillance, the Society of Obstetricians and Gynaecologists of Canada (SOGC) recommended the availability of 1:1 nursing care (1 nurse to 1 patient) for women in active labour. The common perception is that the majority of women in labour and delivery units are in active labour. Identifying the proportion of women in active labour versus those who are not in active labour is crucial for the allocation of nursing care resources. OBJECTIVES: We sought to obtain a quantitative description of our obstetrical population to determine the distribution of women in the labour and delivery (L&D) unit, the obstetrical triage unit, and the labour, delivery, recovery, and postpartum (LDRP) unit and to determine the proportion of women in active labour who were receiving 1:1 nursing care. METHODS: We randomly sampled and surveyed nursing care activities and patient distribution in a 1-hour period each day over a period of 4 months; each hour of the day was assessed on 5 separate occasions. The 3 units (L&D, LDRP, and obstetrical triage) were surveyed simultaneously. RESULTS: In the L&D unit, 31% of women were in active labour; of those, 92% received 1:1 nursing care. The remaining women (69%) were either in the early phase of labour, had significant obstetrical complications, were undergoing Caesarean section, or had just delivered. In the LDRP unit, 13% of women were in active labour, and 87% were postpartum. Almost one-half the women (45%) in the obstetrical triage unit were being assessed for possible labour or possible rupture of membranes, while the remainder were being assessed for other pregnancy-related problems. CONCLUSION: Contrary to common perception, the majority of women in the L&D unit were admitted for reasons other than active labour but required care in that unit. The concept of providing 1:1 nursing care solely to women in active labour would leave the labour units understaffed. We recommend that institutions use a more precise classification system, rather than the presence or absence of labour, to determine individual patient risk and the appropriate nursing resource requirements.
