Abstract

Problem: A cesarean section is a lifesaving procedure for both mothers and neonates when vaginal birth is no longer a safe option. Nonetheless, there has been an extraordinary rise in cesarean rates as well as remarkable variation among hospital systems, individual physicians, and even labor and delivery nurses. Creating awareness of the problem and providing education to the nursing staff regarding labor support techniques can make significant decreases in the cesarean section rates.

Intervention: L&D nurses were educated on non-pharmacologic comfort measures. A presentation, lasting approximately one hour, was presented by the project lead during a mandatory staff meeting on the L&D unit.

Measures: Tools that were utilized for this project included: a presentation that was created by the project lead based on information included in the CMQCC Toolkit to Support Vaginal Birth and Reduce Primary Cesareans, a reference binder, and chart audit tool.

Results: A Phi-Coefficient and Fishers Exact Test calculation were calculated. The Phi-Coefficient r value was calculated at 0.043033148, which places the results in the no or negligible relationship range of .01 - .19. The Fishers Exact Test p value was calculated at 0.818181818, well above the .05 required to imply statistical significance. NTSV cesarean rates in the post-implementation phase did show a reduction compared to the pre-implementation phase.

Conclusions: The pre-implementation NTSV cesarean rate was 20% with a post-implementation NTSV cesarean rate of 16.7%. There are many factors affecting NTSV cesarean sections, but there is strong research that suggests a multitude of interventions that can be performed during labor to prevent one from occurring. Although the sample size was small, the post-implementation rate was lower, further supporting what has been stated in current literature about positive interventions associated with lower NTSV cesarean rates.

Author Details

Micah Vande Vegte, DNP student, micahvandevegte@gmail.com

Sigma Membership

Non-member

Lead Author Affiliation

Nebraska Methodist College, Omaha, Nebraska, USA

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Quality Improvement

Research Approach

Translational Research/Evidence-based Practice

Keywords:

Supporting Vaginal Births, Non-Pharmacologic Comfort Measures, Labor Support Techniques, Cesarean Rate Deduction

Advisor

Krumbach, Jillian

Degree

DNP

Degree Grantor

Nebraska Methodist College

Degree Year

2022

Creative Commons License

Creative Commons Attribution-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-No Derivative Works 3.0 License.

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Review Type

Faculty Approved: Degree-based Submission

Acquisition

Self-submission

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