Abstract
Staffing a labor, delivery, recovery, postpartum (LDRP) unit can be difficult if one uses a numbers-based staffing matrix because of the varying acuity levels of obstetric patients. To better capture patient acuity and staffing needs, each patient seen in our obstetric unit was identified and placed into one of four categories: outpatient, labor, cesarean, or postpartum. After those categories were established and defined, each was assigned a weight. Through use of an hours-per-patient-day (HPPD) target, which was established through National Database of Nursing Quality Indicators benchmarking, an activity-based staffing matrix was designed. This matrix was composed of weights and minimum staffing requirements. After a 6-month testing period, the activity-based staffing matrix was implemented in July 2017. To date, patient category, staffing levels, and weights have been collected at the start of each shift. These data have allowed us to adjust staffing levels on the basis of the needs and acuity of patients and, thus, move toward our HPPD target. Staff has gained a better understanding of why it is important to follow this activity-based staffing matrix and how the collected data are used for staffing purposes. With continual evaluation and adjustments to the matrix, we are confident that we will continue to move toward, and ultimately reach, our target HPPD.
Published Version
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