Evaluating the Impact of an Educational Intervention on Nursing Labor Support Practices and Cesarean Birth Rates.

Abstract

Background: Over 30% of births in the United States occur via cesarean section despite increased risks to the birthing person and neonate. Evidence-based nursing practice related to fetal monitoring, patient positioning, and management of the second stage of labor can decrease the incidence of cesarean birth. Objective: The objective is to decrease the cesarean birth rate by 3% in a Midwestern suburban hospital. Methods: Baseline data on demographics, labor interventions, and birth outcomes were collected for 4 weeks (n = 85 births). The intervention included a sample of 24 labor nurses who took a pretest, viewed a narrated PowerPoint on methods to promote vaginal birth, and completed a posttest. Data were then collected for another four weeks (n = 90 births). Results: The mean improvement in posttest scores was 4.792 points, providing strong evidence that this education would result in a score increase between 3.9 and 5.6 with 95% confidence. There was no increase in the number of nursing interventions utilized during labor. The overall cesarean birth rate increased from 18.8% to 28.9%. Conclusions: The education was highly effective in increasing nurse knowledge, but this did not affect a change in nursing practice or cesarean birth rate. Implications for Nursing: High-quality education is not enough to change practice or outcomes. Additional research is needed on barriers that prevent the translation of knowledge into practice.