Evidence map›Paper›PMID 38569681›Full record

ArticleBMJ open2024

Inpatient midwifery staffing levels and postpartum readmissions: a retrospective multicentre longitudinal study.

Lesley Yvonne Turner, Christina Saville, Jane Ball, David Culliford, Chiara Dall'Ora, Jeremy Jones, Ellen Kitson-Reynolds, Paul Meredith, Peter Griffiths

Open access · goldAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.6field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 citations in OpenAlex.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Lesley Yvonne TurnerSchool of Health Sciences, University of Southampton, Southampton, UK lyt1g19@soton.ac.uk.ORCID 0000-0003-1489-3471
Christina SavilleSchool of Health Sciences, University of Southampton, Southampton, UK.ORCID 0000-0001-7718-5689
Jane BallSchool of Health Sciences, University of Southampton, Southampton, UK.ORCID 0000-0002-8655-2994
David CullifordSchool of Health Sciences, University of Southampton, Southampton, UK.
Chiara Dall'OraSchool of Health Sciences, University of Southampton, Southampton, UK.ORCID 0000-0002-6858-3535
Jeremy JonesSchool of Health Sciences, University of Southampton, Southampton, UK.
Ellen Kitson-ReynoldsSchool of Health Sciences, University of Southampton, Southampton, UK.ORCID 0000-0002-8099-883X
Paul MeredithSchool of Health Sciences, University of Southampton, Southampton, UK.
Peter GriffithsSchool of Health Sciences, University of Southampton, Southampton, UK.ORCID 0000-0003-2439-2857
University of Southampton · GBNIHR Research Delivery Network · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPreventing readmission to hospital after giving birth is a key priority, as rates have been rising along with associated costs. There are many contributing factors to readmission, and some are thought to be preventable. Nurse and midwife understaffing has been linked to deficits in care quality. This study explores the relationship between staffing levels and readmission rates in maternity settings.

methodsWe conducted a retrospective longitudinal study using routinely collected individual patient data in three maternity services in England from 2015 to 2020. Data on admissions, discharges and case-mix were extracted from hospital administration systems. Staffing and workload were calculated in Hours Per Patient day per shift in the first two 12-hour shifts of the index (birth) admission. Postpartum readmissions and staffing exposures for all birthing admissions were entered into a hierarchical multivariable logistic regression model to estimate the odds of readmission when staffing was below the mean level for the maternity service.

results64 250 maternal admissions resulted in birth and 2903 mothers were readmitted within 30 days of discharge (4.5%). Absolute levels of staffing ranged between 2.3 and 4.1 individuals per midwife in the three services. Below average midwifery staffing was associated with higher rates of postpartum readmissions within 7 days of discharge (adjusted OR (aOR) 1.108, 95% CI 1.003 to 1.223). The effect was smaller and not statistically significant for readmissions within 30 days of discharge (aOR 1.080, 95% CI 0.994 to 1.174). Below average maternity assistant staffing was associated with lower rates of postpartum readmissions (7 days, aOR 0.957, 95% CI 0.867 to 1.057; 30 days aOR 0.965, 95% CI 0.887 to 1.049, both not statistically significant).

conclusionWe found evidence that lower than expected midwifery staffing levels is associated with more postpartum readmissions. The nature of the relationship requires further investigation including examining potential mediating factors and reasons for readmission in maternity populations.

Indexed as

MidwiferyFemaleHumansInpatientsLongitudinal StudiesPatient ReadmissionPostpartum PeriodPregnancyRetrospective StudiesWorkforceHuman resource managementNursing CareOBSTETRICSPostpartum Period

Identifiers

PMID38569681
PMCPMC11146407
OpenAlexW4393853363

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.