Analysis of midwives’ situation and the need to measure their workloads

a mixed methodology (quantitative and qualitative), observational, descriptive and cross-sectional study. Two phases were carried out. The first methodological phase consisted of conducting semi-structured individual interviews. The second methodological phase analyzed the Nursing Intervention Classification (NIC) interventions that midwives perform in the labor room during daily practice.

Results:

90.3% of midwives have work overload, since for 80.6% the midwife-pregnant mother ratio is not well established, since the mean execution time of a Nursing Intervention Classification (NIC) intervention is 20 minutes. For this reason, 100% of the sample considers the development of workload measurement tools to be highly useful.

Conclusions:

the need to generate an instrument that considers the diversity of Nursing Intervention Classification (NIC) interventions that develop within the labor room is ratified.

Descriptors:
Midwife; Workloads; Standardized Nursing Terminology; Scale; Burnout

Consequences	Types	n	%
Pregnant woman	Loss of quality service	28	90.3
	Loss of quality of care coupled with poor service organization	2	6.5
	Poor attention due to exhaustion	1	3.2
Newborn	Not being able to provide immediate care and initiation of breastfeeding	7	22.6
	Situation of non-adaptation to extrauterine life	6	19.4
	Loss of quality service	16	51.6
	No initiation of skin-to-skin contact	1	3.2
Professional	Physical-mental overload	6	79.4
	Psychological affection	21	67.7
	Stress and obsolete work	1	3.2
	Burnout	2	6.2

Socio-clinical data	Yes, work overload		No, work overload		p
Socio-clinical data	n	%	n	%	p
Yes, you practiced the nursing profession	27	93.1	2	6.9	.046
No, you did not practice the nursing profession	1	50	1	50	.046
Workloads are adequate	9	75	3	25	.022
Workloads are not adequate	19	100	0	0	.022
Workloads have consequences on the surrogate	28	90.3	3	9.7
Workloads do not have consequences on the surrogate	0	0	0	0
Workloads have consequences on newborns	27	90	3	10	.739
Workloads do not have consequences on newborns	1	100	0	0	.739
Workloads have consequences in midwives	28	90.3	3	9.7
Workloads do not have consequences in midwives	0	0	0	0
The midwife/pregnant ratio is adequate	4	66.7	2	33	.029
The midwife/pregnant ratio is not adequate	24	96	1	4	.029
Yes, workloads need to be measured	28	90.3	3	9.7
No, workloads do not need to be measured	0	0	0	0
Workload measurement tools are useful	27	90	3	10	.739
Workload measurement tools are not useful	1	100	0	0	.739
Workload measurement tools are cost-effective to set the ratio	28	90.3	3	9.7
Workload measurement tools are not cost-effective to set the ratio	0	0	0	0

NIC	Times measured	NIC times
1801. Self care assistance: bathing and hygiene	3	15
6540. Infection control	38	38
2300. Medication administration	4	15
2380. Medication management	4	23
2314. Medication administration: intravenous (IV)	4	15
4200. Intravenous therapy (IV)	4	15
2313. Medication administration: intramuscular (IM)	15	15
2304. Administration of medication: oral	15	15
2318. Medication administration: vaginal	15	15
2311. Medication administration: inhalation	15	15
2214. Analgesic administration: intraspinal	3	23
2319. Medication administration: intraspinal	3	15
7820. Specimen management	2	15
5510. Health education	12	23
5568. Parenteral education: infant	12	38
5244. Lactation counselling	12	38
5618. Teaching: procedure/treatment	12	23
1100. Nutrition management	12	15
3740. Fever treatment	9	23
4190. Intravenous (IV) insertion	5	15
4235. Phlebotomy: cannulated vessel	5	15
4238. Phlebotomy: venous blood sample	5	15
4035. Capillary blood sample	3	15
3620. Suturing	14	23
1750. Perineal care	14	15
6680. Vital signs	2	15
6771. Electronic fetal monitoring: antepartum	60	60
6772. Electronic fetal monitoring: intrapartum	60	60
840. Postural change	1	23
6482. Environmental management: comfort	1	15
7140. Family support	12	60
5250. Decision-making support	12	23
5270. Emotional support	12	23
5420. Spiritual support	12	23
4920. Active listening	12	23
5440. Support system enhancement	12	38
5340. Presence	12	23
5460. Contact	12	15
6710. Attachment promotion	12	22
6800. High-risk pregnancy care	12	60
7310. Admission activities	12	23
6520. Health screening	12	53
6574. Patient identification	12	20
7960. Health care information exchange	1	15
7920. Documentation	15	15
6656. Surveillance: late pregnancy	12	60
7650. Delegation	2	15
8100. Referral	23	23
6720. Birthing	38	60
6830. Intrapartal care	55	60
6834. Intrapartal care: high-risk childbirth	55	60
6972. Resuscitation: fetus	1	60
5294. Grief work facilitation: perinatal death	38	38
1770. Post-mortem care	23	23
6750. Cesarean section care	48	38
2880. Preoperative coordination	48	38
2930. Surgical preparation	48	53
7710. Support for the doctor	14	23
2870. Postanesthesia care	29	53
6824. Infant care: newborn	2	60
6974. Resuscitation: neonate	6	53
6930. Postpartal care	5	60
7370. Discharge planning	5	53
8140. Shift report	4	38
6850. Labor induction	60	60
7840. Supply management	8	23
7980. Incident reporting	1	23
7880. Technology management	3	15
7660. Emergency cart checking	8	15
6486. Environmental management: safety	3	38
6489. Environmental management: worker safety	3	60
8020. Multidisciplinary care conference	6	60
7830. Staff supervision: quality management	60	60
7640. Clinical path development	60	60
8700. Program development	60	60
7800. Quality monitoring	60	60
7726. Preceptor: student	23	60
7222. Preceptor: employee	23	60
8120. Research data collection	23	23
6140. Cardiac arrest	38	38
6320. Resuscitation	23	23
4030. Blood products administration	60	60
580. Urinary catheterization: intermittent	2	15
6630. Seclusion	3	60
1480. Massage	12	15
5880. Calming technique	12	38
1380. Heat/cold application	12	15
2400. Patient-controlled analgesia (PCA) assistance	3	23
1410. Pain management: acute	29	38
4026. Bleeding reduction: postpartum uterus	53	53
6860. Labor suppression	60	60
6870. Lactation suppression	23	23
1052. Bottle feeding	38	38
4021. Bleeding reduction: antepartum uterus	53	53
6522. Breast examination	15	15
2910. Surgical instrumentation management	60	60

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[1] Corresponding author: Lorena Gómez García E-mail: lorenagomez_20@hotmail.com