Abstract
Objective To examine the relationship between nurse-to-patient staffing ratios and perinatal
outcomes in women receiving oxytocin during labor.
Study Design A retrospective analysis of perinatal outcomes in women receiving oxytocin for induction
or augmentation of labor during 2010. Outcomes examined were fetal distress, birth
asphyxia, primary cesarean delivery, chorioamnionitis, endomyometritis, and a composite
of adverse events. Frequency of 1:1 nurse-to-patient staffing was determined for each
hospital. Outcomes were compared between hospitals categorized into quartiles of staffing
ratios.
Results In 208,033 women delivering during 2010, there was no relation between frequency
of 1:1 nurse-to-patient staffing ratio and improved perinatal outcomes. Adoption of
universal 1:1 staffing in the United States would result in the need for an additional
27,000 labor nurses and a cost of $1.6 billion.
Conclusion Available data do not support the imposition of mandatory 1:1 nurse-to-patient staffing
ratios for women receiving oxytocin in all U.S. facilities.
Keywords
oxytocin - nurse staffing - patient safety
