Development and Evaluation of Clinical Nursing Practice Guidelines for Intrapartum Fetal Surveillance in High-Risk Pregnant Women
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Abstract
Abstract
High-risk pregnancy referred to a condition in which maternal or fetal factors increased the risk of complications during pregnancy and childbirth. The intrapartum period was particularly critical for fetal safety. Developing evidence-based nursing practice guidelines for intrapartum fetal surveillance in high-risk pregnancies was therefore essential to improve the quality and safety of maternal and neonatal care. This research and development study aimed to develop and evaluate the effectiveness of nursing practice guidelines for intrapartum fetal surveillance among women with high-risk pregnancies. The study sample consisted of 102 women with high-risk pregnancies, divided into a control group (n = 51) and an experimental group (n = 51), and 20 registered nurses working in the labor room. Research instruments included the nursing practice guidelines for intrapartum fetal surveillance in high-risk pregnancies, a knowledge test, and a satisfaction questionnaire for registered nurses. Data were analyzed using descriptive statistics, paired samples t-test, independent samples t-test, and chi-square test.
The developed guidelines consisted of four main components: (1) classification of risk levels among women in labor, (2) fetal surveillance using Electronic Fetal Monitoring (EFM), (3) response to fetal distress, and (4) interdisciplinary team communication using the SBAR technique. After implementation of the guidelines, the rates of fetal distress and birth asphyxia in the experimental group were significantly lower than those in the control group receiving routine care (p < 0.05). In addition, the mean scores of nurses’ knowledge and satisfaction after guideline implementation were significantly higher than those before implementation (p < 0.05). These findings indicated that the developed nursing practice guidelines enhanced the effectiveness of intrapartum fetal surveillance, reduced neonatal complications, and supported safer and higher-quality nursing care.
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References
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