A 5-week programme of breastfeeding inservice education, included classes on a repeated series of three topics, a film, provision of reading material, tests and the availability of a nurse-clinician for consultation and assistance. The study was carried out in a 50-bed maternity unit. Participation was voluntary. Of the 112 registered nurses and 42 practical nurses, between one-third and one-half participated in one or more of the various aspects. Follow-up tests revealed considerable disagreement among the staff on knowledge and nursing interventions related to breastfeeding.
To determine the efficacy of an educational intervention in changing nurses' satisfaction and comfort with and their knowledge and use of a newly introduced analgesic agent, fentanyl, to manage pain during labour.
A written survey was completed by 19 labour and delivery nurses before and after the educational intervention in a small Northern Canadian city.
Prior to the educational intervention, respondents rated their knowledge of and comfort with use of morphine and meperidine as significantly greater than their knowledge of and comfort with use of fentanyl (P
To quantify practice changes associated with implementing a clinical practice guideline for the second stage of labor in term nulliparous women with epidural anesthesia and to describe the lessons learned about knowledge translation. The main clinical practice guideline recommendation was waiting up to 2 hours before pushing after full dilatation.
Pre- and post-evaluation of clinical outcomes and knowledge translation strategies associated with implementing the second stage of labor clinical practice guideline at two birthing units within a large teaching hospital.
The implementation of the clinical practice guideline resulted in a significant increase in median waiting time before pushing of 33 minutes at Site 1. This change was also reflected in the twofold increase in the proportion of women waiting longer than 120 minutes before pushing at this site. There was no change in waiting time at Site 2. The duration of the second stage did not change significantly at either site. The median pushing time decreased at both sites but was only statistically significant at Site 1.
Bringing about practice change in obstetrics is complex. The measured change in this study was less than we expected. Greater success might have been achieved by enhancing feedback to care providers and more frequent audits of practice. We need to better understand the subtle influences in attitude and culture that prevented successful implementation in one site. For units considering a similar process, we recommend a commensurately greater level of presence in the units to encourage compliance with the clinical practice guideline in order to achieve the desired level of practice change.
To examine the determinants of nurses' intentions to practice continuous labor support.
A descriptive survey based on the Theory of Planned Behavior.
A large, urban Canadian hospital with 2 sites and 7,000 births per year.
Ninety-seven registered nurses from 2 birthing units.
Scores measuring nurses' attitudes, subjective norms, and intentions regarding continuous labor support for women with epidural analgesia were significantly lower than those for women without epidural analgesia (p
Comment In: MCN Am J Matern Child Nurs. 2009 Jan-Feb;34(1):6919104327