title: The clinical and economic impact of nurse to patient staffing ratios in women receiving intrapartum oxytocin.
abstract: OBJECTIVE
  To examine the relationship between nurse-to-patient staffing ratios and perinatal outcomes in women receiving oxytocin during labor.
  
  
  METHODS
  A retrospective analysis of perinatal outcomes in women receiving oxytocin for induction or augmentation of labor during 2010. Outcomes examined were fetal distress, birth asphyxia, primary cesarean delivery, chorioamnionitis, endomyometritis, and a composite of adverse events. Frequency of 1:1 nurse-to-patient staffing was determined for each hospital. Outcomes were compared between hospitals categorized into quartiles of staffing ratios.
  
  
  RESULTS
  In 208,033 women delivering during 2010, there was no relation between frequency of 1:1 nurse-to-patient staffing ratio and improved perinatal outcomes. Adoption of universal 1:1 staffing in the United States would result in the need for an additional 27,000 labor nurses and a cost of $1.6 billion.
  
  
  CONCLUSIONS
  Available data do not support the imposition of mandatory 1:1 nurse-to-patient staffing ratios for women receiving oxytocin in all U.S. facilities.
authors.affiliation: Women's and Children's Clinical Service Group, Hospital Corporation of America and the University of Texas Medical Branch, Galveston, Texas.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Clark
authors.affiliation: Women's and Children's Clinical Service Group, Hospital Corporation of America and the University of Texas Medical Branch, Galveston, Texas.
authors.forename: George A
authors.initials: GA
authors.lastname: Saade
authors.affiliation: Women's and Children's Clinical Service Group, Hospital Corporation of America and the University of Texas Medical Branch, Galveston, Texas.
authors.forename: Janet A
authors.initials: JA
authors.lastname: Meyers
authors.affiliation: Women's and Children's Clinical Service Group, Hospital Corporation of America and the University of Texas Medical Branch, Galveston, Texas.
authors.forename: Donna R
authors.initials: DR
authors.lastname: Frye
authors.affiliation: Women's and Children's Clinical Service Group, Hospital Corporation of America and the University of Texas Medical Branch, Galveston, Texas.
authors.forename: Jonathan B
authors.initials: JB
authors.lastname: Perlin
mesh_terms: D001238:Asphyxia Neonatorum / Q000453:epidemiology; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000191:economics / Q000451:nursing*; D007743:Labor, Obstetric; D009741:Nursing Staff, Hospital / Q000191:economics / Q000592:standards*; D009775:Obstetrics and Gynecology Department, Hospital / Q000191:economics / Q000592:standards; D010121:Oxytocin / Q000627:therapeutic use*; D010561:Personnel Staffing and Scheduling / Q000592:standards*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D014481:United States; D000078329:Workforce; D016526:Workload
chemical_list: D010121:Oxytocin