Is midwife workload associated with quality of care (continuous electronic fetal monitoring [CEFM])and neonatal outcome indicators? A prospective study in consultant-led labour wards in Scotland

Janet Stephen Tucker, G. Parry, Gillian Penney, M. Page, Vanora Hundley

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Evidence for staffing recommendations in labour wards is scant. This study aimed to test association between midwife workload with adjusted process of continuous electronic fetal monitoring (CEFM) and neonatal outcome indicators. This was a prospective workload study in 23 consultant-led labour wards in Scotland. There were 3489 livebirths during September 2000, and 1561 consecutively delivered women with CEFM case review during the mid-two weeks. Process measures were: adjusted rates of CEFM, appropriate CEFM, and time to medical response for a serious fetal heart trace abnormality. Neonatal outcome indicators were: Apgar score < 7 at 5 minutes, admission to neonatal unit (NNU) > 48 hours, and neonatal resuscitation. Complete information was available for 99% (2553/2576) of workload time points, 99% (1559) of CEFM process, and 3083 eligible neonates. There were no associations between occupancy or staffing ratios and adjusted CEFM process, Apgar < 7 at 5 minutes (0.98 [0.83, 1.15]) or admission to NNU for > 48 hours (0.97 [0.95, 1.00]). However, there was association between increasing staffing ratios and lower odds of adjusted neonatal resuscitation (excluding bag and mask only) (0.97 [0.94, 0.99]). The direction of effect of increasing workload suggests detriment to outcome indicators, although the size of effect may be small.

Original languageEnglish
Pages (from-to)369-377
Number of pages8
JournalPaediatric and Perinatal Epidemiology
Volume17
Issue number4
DOIs
Publication statusPublished - Oct 2003

Keywords

  • INTENSIVE-CARE
  • MORTALITY
  • UNITS

Cite this

Is midwife workload associated with quality of care (continuous electronic fetal monitoring [CEFM])and neonatal outcome indicators? A prospective study in consultant-led labour wards in Scotland. / Tucker, Janet Stephen; Parry, G.; Penney, Gillian; Page, M.; Hundley, Vanora.

In: Paediatric and Perinatal Epidemiology, Vol. 17, No. 4, 10.2003, p. 369-377.

Research output: Contribution to journalArticle

@article{e386213bfb5d47268382bc40534cc2ae,
title = "Is midwife workload associated with quality of care (continuous electronic fetal monitoring [CEFM])and neonatal outcome indicators? A prospective study in consultant-led labour wards in Scotland",
abstract = "Evidence for staffing recommendations in labour wards is scant. This study aimed to test association between midwife workload with adjusted process of continuous electronic fetal monitoring (CEFM) and neonatal outcome indicators. This was a prospective workload study in 23 consultant-led labour wards in Scotland. There were 3489 livebirths during September 2000, and 1561 consecutively delivered women with CEFM case review during the mid-two weeks. Process measures were: adjusted rates of CEFM, appropriate CEFM, and time to medical response for a serious fetal heart trace abnormality. Neonatal outcome indicators were: Apgar score < 7 at 5 minutes, admission to neonatal unit (NNU) > 48 hours, and neonatal resuscitation. Complete information was available for 99{\%} (2553/2576) of workload time points, 99{\%} (1559) of CEFM process, and 3083 eligible neonates. There were no associations between occupancy or staffing ratios and adjusted CEFM process, Apgar < 7 at 5 minutes (0.98 [0.83, 1.15]) or admission to NNU for > 48 hours (0.97 [0.95, 1.00]). However, there was association between increasing staffing ratios and lower odds of adjusted neonatal resuscitation (excluding bag and mask only) (0.97 [0.94, 0.99]). The direction of effect of increasing workload suggests detriment to outcome indicators, although the size of effect may be small.",
keywords = "INTENSIVE-CARE, MORTALITY, UNITS",
author = "Tucker, {Janet Stephen} and G. Parry and Gillian Penney and M. Page and Vanora Hundley",
year = "2003",
month = "10",
doi = "10.1046/j.1365-3016.2003.00524.x",
language = "English",
volume = "17",
pages = "369--377",
journal = "Paediatric and Perinatal Epidemiology",
issn = "0269-5022",
publisher = "Wiley-Blackwell",
number = "4",

}

TY - JOUR

T1 - Is midwife workload associated with quality of care (continuous electronic fetal monitoring [CEFM])and neonatal outcome indicators? A prospective study in consultant-led labour wards in Scotland

AU - Tucker, Janet Stephen

AU - Parry, G.

AU - Penney, Gillian

AU - Page, M.

AU - Hundley, Vanora

PY - 2003/10

Y1 - 2003/10

N2 - Evidence for staffing recommendations in labour wards is scant. This study aimed to test association between midwife workload with adjusted process of continuous electronic fetal monitoring (CEFM) and neonatal outcome indicators. This was a prospective workload study in 23 consultant-led labour wards in Scotland. There were 3489 livebirths during September 2000, and 1561 consecutively delivered women with CEFM case review during the mid-two weeks. Process measures were: adjusted rates of CEFM, appropriate CEFM, and time to medical response for a serious fetal heart trace abnormality. Neonatal outcome indicators were: Apgar score < 7 at 5 minutes, admission to neonatal unit (NNU) > 48 hours, and neonatal resuscitation. Complete information was available for 99% (2553/2576) of workload time points, 99% (1559) of CEFM process, and 3083 eligible neonates. There were no associations between occupancy or staffing ratios and adjusted CEFM process, Apgar < 7 at 5 minutes (0.98 [0.83, 1.15]) or admission to NNU for > 48 hours (0.97 [0.95, 1.00]). However, there was association between increasing staffing ratios and lower odds of adjusted neonatal resuscitation (excluding bag and mask only) (0.97 [0.94, 0.99]). The direction of effect of increasing workload suggests detriment to outcome indicators, although the size of effect may be small.

AB - Evidence for staffing recommendations in labour wards is scant. This study aimed to test association between midwife workload with adjusted process of continuous electronic fetal monitoring (CEFM) and neonatal outcome indicators. This was a prospective workload study in 23 consultant-led labour wards in Scotland. There were 3489 livebirths during September 2000, and 1561 consecutively delivered women with CEFM case review during the mid-two weeks. Process measures were: adjusted rates of CEFM, appropriate CEFM, and time to medical response for a serious fetal heart trace abnormality. Neonatal outcome indicators were: Apgar score < 7 at 5 minutes, admission to neonatal unit (NNU) > 48 hours, and neonatal resuscitation. Complete information was available for 99% (2553/2576) of workload time points, 99% (1559) of CEFM process, and 3083 eligible neonates. There were no associations between occupancy or staffing ratios and adjusted CEFM process, Apgar < 7 at 5 minutes (0.98 [0.83, 1.15]) or admission to NNU for > 48 hours (0.97 [0.95, 1.00]). However, there was association between increasing staffing ratios and lower odds of adjusted neonatal resuscitation (excluding bag and mask only) (0.97 [0.94, 0.99]). The direction of effect of increasing workload suggests detriment to outcome indicators, although the size of effect may be small.

KW - INTENSIVE-CARE

KW - MORTALITY

KW - UNITS

U2 - 10.1046/j.1365-3016.2003.00524.x

DO - 10.1046/j.1365-3016.2003.00524.x

M3 - Article

VL - 17

SP - 369

EP - 377

JO - Paediatric and Perinatal Epidemiology

JF - Paediatric and Perinatal Epidemiology

SN - 0269-5022

IS - 4

ER -