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Consequences of Delayed, Unfinished, or Missed Nursing Care During Labor and Birth

Simpson, Kathleen Rice PhD, RNC, CNS-BC, FAAN; Lyndon, Audrey PhD, RNC, FAAN

The Journal of Perinatal & Neonatal Nursing: January/March 2017 - Volume 31 - Issue 1 - p 32–40
doi: 10.1097/JPN.0000000000000203
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The purpose of this study was to examine the concept of delayed, unfinished, or missed nursing care when patient census and acuity exceed nurse staffing resources with nurses who care for women during labor and birth. Focus groups were held during which labor nurses were asked about aspects of nursing care that may be regularly delayed, unfinished, or completely missed during labor and birth, including possible reasons and potential consequences. Seventy-one labor nurses participated in 11 focus groups in 6 hospitals. Nurses focused on support and encouragement as aspects of care that they felt are essential but often not able to be performed when the unit is busy. Nurses seemed to assume technical features of care as a “given” in the background and not always noticed unless missed. They voiced concerns about risks to maternal and fetal well-being when they were short-staffed. Potential outcomes were discussed including cesarean birth, depressed infants at birth, hemorrhage, and negative effects on patient satisfaction, successful breast-feeding, and the overall patient experience.

Conclusion: When essential aspects of nursing care are delayed, unfinished, or completely missed, there are potentially negative implications for numerous patient outcomes and patient safety is at risk.

Mercy Hospital St. Louis, St Louis, Missouri (Dr Simpson); and Department of Family Health Care Nursing, UCSF School of Nursing, San Francisco, California (Dr Lyndon).

Corresponding Author: Kathleen Rice Simpson, PhD, RNC, CNS-BC, FAAN, 7140 Pershing Avenue, St Louis, MO 63130 (krsimpson@prodiogy.net).

This study was funded by the Association of Women's Health, Obstetrics, and Neonatal Nurses.

Disclosure: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

Submitted for publication: May 9, 2016; accepted for publication: June 3, 2016.

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