Nurse-Led Educational Intervention on Maternal Repositioning in Reducing Variable Fetal Heart Rate Deceleration

Abstract

Background: Variable Decelerations is an abnormal fetal heart rate patterns and it is related to umbilical cord compression, and it needs immediate medical attention.
Objective: The purpose of this study was to assess the effect of nurse-led educational intervention on nurses' knowledge regarding fetal heart rate monitoring, interpretation and repositioning of the mother in the care of variable fetal heart rate deceleration during child birth.
Methodology: A Pre–post Quasi-experimental study was carried out in Gynecology Department of Nawab Sir Sadiq Abbasi Hospital, Bahawalpur. A total of 46 registered nurses were recruited in the study using convenient sampling technique. A preliminary and follow-up structured 25 item nurses' knowledge questionnaire about FHR monitoring, normal baseline FHR, FHR variability, early and late decelerations, variable deceleration, cardiotocography, VEAL-CHOP, maternal repositioning, nursing interventions, reassessment, documentation and fetal response was administered pre and post educational intervention.
Results: Mean FHR was found to decrease from baseline 145.92 ± 18.37 to 130.58 ± 19.77 after interventions (t = 5.812; p < 0.001). The mean knowledge score was significantly higher after the intervention at 96.89 ± 5.19 compared to pre-intervention at 54.80 ± 5.77. Statistically significant difference was found by Wilcoxon signed ranks test (Z = -5.907, p < 0.001).
Conclusions: The overall results of the study suggest that maternal repositioning is a safe, cost effective and clinically useful intervention and nurse led educational programs are highly effective in improving knowledge and practice. Ongoing education and training, therefore, are necessary to improve clinical competence and maternal & fetal outcomes.