References
Measure to improve: a pilot study of Birthrate Plus in the Netherlands
Abstract
Background/Aims
Evidence-based standards are an important means for ensuring safe and effective care for birthing women. The provision of one-to-one care for women in labour is one such standard, which should be the norm in Dutch maternity care. However, no audit measures of this standard are available. This study examined the use of Birthrate Plus, a validated instrument for the measurement of patient acuity. This tool has the added benefit of allowing measurement of birth characteristics in relation to staffing numbers, providing a basis for auditing the standard of one-to-one care for women in labour in hospitals in the Netherlands.
Methods
This pilot study used the Birthrate Plus tool to retrospectively examine birth characteristics and staffing levels in a 4-month period, in five hospitals in the Netherlands.
Results
The review of 11 582 patient cases found that most births in the sample were classified as occurring in the higher acuity levels of Birthrate+ tool. Examination of staffing levels showed that when comparing actual staffing levels with recommended levels, hospitals had a shortfall of between 47% and 64%.
Conclusions
The Birthrate Plus tool could be useful in auditing staffing levels in Dutch maternity care. Analysis of the data provided by hospitals in the sample showed that none were able to meet the Dutch standard of providing consistent one-one-one care.
Evidence-based standards are an important means for ensuring safe and effective care for birthing women (World Health Organization, 2021). The provision of one-to-one care for women in labour is one such standard. Research shows that one-to-one care in labour is associated with better outcomes and higher levels of satisfaction for mothers (Hodnett et al, 2012; National Institute for Health and Care Excellence (NICE), 2014; Bohren et al, 2017; Sosa et al, 2018; Bjerga et al, 2019; Buerengen et al, 2022). However, the provision of one-to-one care is difficult to provide and measure. It is difficult to find and retain the number of staff required to offer such care (Harrington et al, 2020). Additionally, lacking a tool to measure staffing levels in relation to the acuity level of those being cared for makes it impossible to know how many staff are needed (NICE, 2015).
Register now to continue reading
Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:
What's included
-
Limited access to our clinical or professional articles
-
New content and clinical newsletter updates each month