In this issue of MCN, we offer three articles on innovative strategies to promote safe, high-quality nursing care in the maternity, neonatal, and pediatric acute care setting. Each of these articles presents approaches that are creative but given what we know about the electronic health record (EHR), equipment linked to the EHR, and the evidence for creating a health care workforce that reflects the population we serve, these strategies should have been in place for years. Every labor and delivery unit and every neonatal intensive care unit (NICU) have EHRs and equipment such as patient monitors that collect data sent to the EHR. These represent a vast source of data that can be used in real-time and retrospectively based on unit census and acuity history to predict nurse staffing.

Embedding the nurse staffing standards from the Association of Women's Health, Obstetric, and Neonatal Nurses (2022) into the EHR provides a framework to identify gaps between patient needs and available nurses. Jones and Hall worked with staff nurses, nurse leaders, and information technology experts to develop an algorithm that identifies patient acuity level, essential care, and nurse staffing requirements to provide safe high-quality care. A number of key reports were built in the EHR to inform the nursing leadership team about nurse staffing on a real-time and historical basis. The reports provided objective data that supported a budgetary increase in nurse staffing and a more flexible nurse staffing scheduling system to meet the needs of the patients. The project was successfully implemented in all four of the maternity units in the Johns Hopkins Health System.

Feldman and Rohan evaluated multiple sources of data that can inform nurse staffing decision-making in the NICU. Workload estimations and acuity measures for preshift staffing can be upgraded using technology and predictive analytics. Nurse staffing decisions affected by intrashift factor variability can be enhanced using novel care models that decentralize decision-making. Improving NICU staffing requires a deliberate, systematic, data-driven approach, with commitment from nurses, resources from the management team, and an institutional culture prioritizing patient safety. They provide a detailed overview of how these data can be useful for nurse leaders involved in staffing decisions.

Nursing and human resource leaders at Boston Children's Hospital, a tertiary care, 415-bed pediatric academic medical center in Massachusetts, developed, implemented, and evaluated specific strategies to increase racial and ethnic diversity in recruitment and hiring of the nursing workforce. These strategies centered on cultivating partnerships, building relationships with candidates, and supporting transition into practice which then led to significant increases in racial and ethnic diversity recruitment and hiring. Nurses and health care leaders must develop strategic diversity recruitment and retention programs to advance health equity by creation of a racially and ethnically diverse nursing workforce that reflects the population served.

Please enjoy these articles on nurse staffing and share them with your colleagues. At MCN, we are always interested in quality manuscripts about various aspects of nurse staffing in the maternal child nursing setting.

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