TABLE 4.
Generalized Structural Equation Modeling of Nurse Staffing and Missed Nursing Care on Exclusive Breast Milk Feeding (EBMF) Rate at the Hospital Level (N = 158 Hospitals)
| Effects | Coefficient | 95% CI | p |
|---|---|---|---|
| Nurse staffing → Missed nursing care overall → EBMF rate | |||
| Total effect | 0.136 | [0.081, 0.190] | <.001 |
| Direct effect | 0.123 | [0.064, 0.183] | <.001 |
| Indirect effect | 0.012 | [−0.008, 0.033] | .236 |
| Nurse staffing → Missed skin-to-skin mother–baby care after birth → EBMF rate | |||
| Total effect | 0.133 | [0.080, 0.187] | <.001 |
| Direct effect | 0.098 | [0.047, 0.148] | <.001 |
| Indirect effect | 0.035 | [0.012, 0.059] | .003 |
| Nurse staffing → Missed breastfeeding within 1 hour after birth → EBMF rate | |||
| Total effect | 0.134 | [0.081, 0.188] | <.001 |
| Direct effect | 0.106 | [0.054, 0.157] | <.001 |
| Indirect effect | 0.029 | [0.008, 0.051] | .007 |
| Nurse staffing → Missed recovery care → EBMF rate | |||
| Total effect | 0.138 | [0.083, 0.193] | <.001 |
| Direct effect | 0.136 | [0.079, 0.194] | <.001 |
| Indirect effect | 0.001 | [−0.014, 0.017] | .860 |
Note. Covariates were controlled in mediation models, including safety climate, annual birth volume, hospital ownership, obstetric level, neonatal intensive care hospital, mean years of experience as a labor nurse, and proportion of respondents with BSN degree or above. CI = confidence interval.