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To examine variation in nursing resources across three different types of maternity units in five regions of the United States.
Maternity units in hospitals in 48 states and the District of Columbia that participated in the 2016 National Database of Nursing Quality Indicator survey.
Staff nurses (N = 19,486) who worked in 707 maternity units.
We conducted a secondary analysis of survey data examining nursing resources (work environment, staffing, education, specialty certification) by type of maternity unit, including labor and delivery, labor/delivery/recovery/postpartum, and postpartum. We used descriptive statistics and analysis of variance.
Participants worked in 707 units (269 labor and delivery units, 164 labor/delivery/recovery/postpartum units, and 274 postpartum units) in 444 hospitals. The work environment was not significantly different across unit types (mean = 2.89–2.94, p = .27). Staffing, education, and specialty certification varied significantly across the unit types (p ≤ .001). In terms of staffing, postpartum units had, on average, almost twice the number of patients per nurse as labor and delivery units (7.51 patients/nurse vs. 4.01 patients/nurse, p ≤ .001) and 1.5 times more patients than labor/delivery/recovery/postpartum units (5.04 patients/nurse vs. 4.01 patients/nurse, p ≤ .001).
Nursing resources varied significantly across types of maternity units and regions of the United States. This variation suggests that improving nursing resources may be a system-level target for improving maternity care in the United States.
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