Implementing AWHONN's Perinatal Staffing Guidelines: Curing the Staffing Blues and Transforming a Unit

Abstract

Professional Issues Poster Presentation Purpose for the Program Improve patient outcomes, quality of care, and nurse satisfaction by following the updated staffing guidelines of the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN). Proposed Change To transition to an all registered nurse (RN) staff while meeting staffing ratios in a defined time frame. Implementation, Outcomes, and Evaluation To meet AWHONN's professional perinatal staffing guidelines released in 2010, leadership advocated for an all RN staff for the mother–infant unit. This skill mix change involved finding new roles for 11 licensed practical nurses (LPNs) employed both in the nursery and caring for mother–baby couplets. Leadership collaborated with the human resources department to identify various departments within Bon Secours seeking LPNs. Informational sessions were held so they could stay within the organization. Leadership advocated for increased hours per patient day in the mother–infant unit so practice would comply with the recently updated AWHONN staffing guidelines. Transformation in the mother–infant unit over the past year has taken place after the implementation of the AWHONN guidelines. This is evidenced by increased Gallup RN satisfaction scores from 4.55 in 2011 to 4.88 in 2012. Certifications have increased from three certified nurses to 22 certified nurses and quality of care has risen. Patient satisfaction scores have also steadily increased. Implications for Nursing Practice Before this change, the RN was responsible for the outcome of care for six to eight couplets if the RN was caring for his/her own assignment of patients and directing care for the LPN's patients. Modification of our staffing guidelines decreased workload and individual responsibility, which allowed for unified teamwork. Now the RN has more time at the bedside and spends less time making daily and shift‐to‐shift staffing decisions.