The association between midwifery staffing levels and the experiences of mothers on postnatal wards: Cross sectional analysis of routine data

Turner, Lesley; Culliford, David; Ball, Jane; Kitson-Reynolds, Ellen; Griffiths, Peter

doi:10.1016/j.wombi.2022.02.005

Cited by 7 publications

(9 citation statements)

References 26 publications

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“…Areas of incomplete care include emotional support, communication, monitoring, breastfeeding support, and parent education when staffing is inadequate [ 14 ]. A previous study using the CQC Maternity Survey data found a relationship between Trust FTE midwives and better postnatal experience [ 31 ]. This finding has been replicated using the 2019 Maternity Survey data in this study.…”

Section: Discussionmentioning

confidence: 99%

“…Trust), for the same Trusts covered by the HPPD data. The newly obtained 2019 dataset was used to confirm or counter our previous published findings relating staffing to patient experience [ 31 ]. We included Full Time Equivalent midwives and medical staff employed in Obstetrics and Gynaecology [ 39 ] although support worker figures could not be ascertained for this speciality.…”

Section: Methodsmentioning

confidence: 99%

“…The null model was a two-level random intercept model with no predictors to explore the extent of between-trust variation in the outcomes. Covariates of mothers’ age group, ethnicity, parity, type of birth and midwifery staffing measures were included in the main model as these characteristics have been shown to contribute to variability in clinical outcomes and patient experience measures [ 26 , 31 , 43 ]. Additional covariates of survey response rate, number of births in each Trust and obstetric/gynaecological medical staffing were added to the main model and were retained only if the model fit improved.…”

Section: Methodsmentioning

confidence: 99%

“…Although staffing is implicated in findings of postnatal dissatisfaction [30] there have been few studies examining this relationship. One cross sectional study found that higher registered midwife workforce is associated with a better postnatal care experience, as measured by the Care Quality Commission (CQC) Maternity Survey in England [31]. This study measured staffing at an organisational level across the whole maternity service.…”

Section: Introductionmentioning

confidence: 99%

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Exploring the relationship between women’s experience of postnatal care and reported staffing measures: An observational study

et al. 2022

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Background Women have reported dissatisfaction with care received on postnatal wards and this area has been highlighted for improvement. Studies have shown an association between midwifery staffing levels and postnatal care experiences, but so far, the influence of registered and support staff deployed in postnatal wards has not been studied. This work is timely as the number of support workers has increased in the workforce and there has been little research on skill mix to date. Methods Cross sectional secondary analysis including 13,264 women from 123 postnatal wards within 93 hospital Trusts. Staffing was measured in each organisation as Full Time Equivalent staff employed per 100 births, and on postnatal wards, using Hours Per Patient Day. Women’s experiences were assessed using four items from the 2019 national maternity survey. Multilevel logistic regression models were used to examine relationships and adjust for maternal age, parity, ethnicity, type of birth, and medical staff. Results Trusts with higher levels of midwifery staffing had higher rates of women reporting positive experiences of postnatal care. However, looking at staffing on postnatal wards, there was no evidence of an association between registered nurses and midwives hours per patient day and patient experience. Wards with higher levels of support worker staffing were associated with higher rates of women reporting they had help when they needed it and were treated with kindness and understanding. Conclusion The relationship between reported registered staffing levels on postnatal wards and women’s experience is uncertain. Further work should be carried out to examine why relationships observed using whole Trust staffing were not replicated closer to the patient, with reported postnatal ward staffing. It is possible that recorded staffing levels on postnatal wards do not actually reflect staff deployment if midwives are floated to cover delivery units. This study highlights the potential contribution of support workers in providing quality care on postnatal wards.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Exploring the relationship between women’s experience of postnatal care and reported staffing measures: An observational study

et al. 2022

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“…It is well documented that poor staffing levels can be problematic; staffing is an operational issue that can impact the ability of staff to provide appropriate care for women and their babies. Turner et al [ 27 ] discuss that staffing, workloads, and communication between staff and patients can impact on postnatal care delivery within the postnatal ward. Relationships between women and midwives are important.…”

Section: Discussionmentioning

confidence: 99%

Exploring Women’s Experiences of Maternity Service Delivery in Regional Tasmania: A Descriptive Qualitative Study

et al. 2022

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The objective of this study is to explore and understand the experiences of women who receive antenatal, birthing, and postnatal care from an integrated maternity services model in a regional area in Tasmania, Australia. This descriptive qualitative study included semi-structured, one-on-one interviews with 14 mothers aged >18 years, who were living in a regional area of Tasmania and had accessed maternity health services. Thematic analysis revealed three key themes: (i) talking about me, (ii) is this normal? and (iii) care practices. Overall, women cited mostly negative experiences from a poorly implemented fragmented service. These experiences included feelings of isolation, frustration over receiving conflicting advice, feeling ignored, and minimal to no continuity of care. In contrast, women also experienced the euphoric feelings of birth, immense support, guidance, and encouragement. Regional women’s experiences of maternity care may be improved if health services work towards place-based continuity of care models. These models should be informed by the local women’s experiences and needs in order to achieve better communication, reduce feelings of isolation, and promote positive breastfeeding experiences.

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First-time parents’ perception of midwives’ and other healthcare professionals’ support behaviours: A qualitative study

Schobinger,

Vanetti,

Ramelet

et al. 2024

Midwifery

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The association between midwifery staffing levels and the experiences of mothers on postnatal wards: Cross sectional analysis of routine data

Cited by 7 publications

References 26 publications

Exploring the relationship between women’s experience of postnatal care and reported staffing measures: An observational study

Exploring the relationship between women’s experience of postnatal care and reported staffing measures: An observational study

Exploring Women’s Experiences of Maternity Service Delivery in Regional Tasmania: A Descriptive Qualitative Study

First-time parents’ perception of midwives’ and other healthcare professionals’ support behaviours: A qualitative study

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