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Implementing a Respectful Maternity Care Guideline During Childbirth Experiences.

Catherine M Hill, Heidi Collins Fantasia, Shawana Burnette

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    Summary

    An evidence-based guideline on respectful maternity care did not significantly change nurses' attitudes after three months. However, scores shifted towards a physiologic model of care, indicating potential for future positive shifts with longer exposure.

    Keywords:
    evidence-based guidelineintrapartumnurses’ attitudes and beliefsnursing practice guidelinesquality improvementrespectful maternity care

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    Area of Science:

    • Maternal Health
    • Nursing Education
    • Quality Improvement

    Background:

    • Respectful maternity care is crucial for vulnerable laboring patients.
    • Nurses' attitudes and beliefs significantly influence childbirth practices.
    • Understanding these attitudes is key to identifying barriers to respectful care.

    Purpose of the Study:

    • To evaluate the impact of an evidence-based guideline on respectful maternity care.
    • To assess changes in intrapartum nurses' attitudes and beliefs regarding childbirth practices.

    Main Methods:

    • A pilot quality improvement project utilized a pretest/posttest design.
    • Intrapartum nurses (n=9) at a tertiary care center participated.
    • Intervention included webinars, guideline access, huddles, and a journal club; attitudes measured by the Nurse Attitudes and Beliefs Questionnaire-Revised.

    Main Results:

    • No statistically significant change in overall nurse attitudes and beliefs after 3 months (p = .058).
    • Aggregate scores increased by 5.6 points, suggesting a trend towards a physiologic model of care.
    • Subscales 'Medical Model of Conflict' and 'Women's Autonomy' showed the greatest score increases.

    Conclusions:

    • A 3-month intervention did not yield significant changes in nurses' attitudes toward respectful maternity care.
    • Increased scores in specific subscales suggest a potential shift in beliefs.
    • Longer exposure to respectful maternity care programs may be necessary to effect measurable changes in attitudes and beliefs.