The Art of Staffing in Labor and Delivery: A Tool to Quantify Staffing Demands


Poster Presentation

Purpose for the Program

In large and small labor and delivery (L&D) units nationwide staffing for patient needs can be overwhelming. Though those on the units know they are busy, there has been very little proof to relay to administration and leadership peers just how busy the unit can become or how quickly patient acuity fluctuates with little predictability. The WIDOC tool was developed as an L&D acuity tracking tool that quantifies the staffing pressure felt in all L&D units. Through use of this tool to track acuity (patient flow and adequacy of staffing) a platform is created for developing a common ground in communicating the needs of the unit to administration.

Proposed Change

Each L&D unit strives to not only provide safe and quality care to our patient population, but also provide exceptional delivery experiences for our growing families. We are challenged with finding ways to adequately staff for these events without having patients feel like nursing staff did not have adequate time to provide the needed care and desired experiences. The implementation of use of the WIDOC tool allows the L&D units to track patient acuity, patient flow, and adequacy of staffing. In addition, staff, fellow leaders and administration need to receive education to understand the tool, what it measures, and what they can do to provide support to the L&D unit in times of need.

Implementation, Outcomes, and Evaluation

The WIDOC tool was originally developed to simply track acuity on a busy L&D unit. After data collection using the first version and input from staff using the tool, it was expanded to include the element of patient flow to more accurately capture the true state of the unit. We are currently in the process of validating the tool and collecting data following the WIDOC tool revision. In early 2013, we will evaluate if all information needed to safely staff the unit is included in the WIDOC tool.

Implications for Nursing Practice

The WIDOC tool gives charge nurses a communication tool to help those outside of L&D understand the current state of the unit and helps leaders and administrators understand measures they can take to assist in turbulent environments. In addition, it gives the charge nurse a toll that can be used to predict what the unit acuity will look like at a specified time to be proactive in summoning help as needed. It also has proven useful in management of productivity.