Date of Graduation

Spring 5-18-2023

Document Access

Restricted Project/Capstone - USF access only

Degree Name

Master of Science in Nursing (MSN)


School of Nursing and Health Professions


MSN project

First Advisor

Dr. Nicole Beamish, DNP, APRN, PHN, CNL


In an effort to reduce rates of unplanned cesarean sections related to labor dystocia, or failure to progress, this quality improvement project aims to increase labor and delivery nursing staff confidence on utilizing evidence-based maternal positions that promote fetal descent. The project was conducted on a labor and delivery unit in a south Bay Area County hospital, which services a patient population with complex medical needs. After conducting literature searches on evidence-based labor positions for the first and second stages of labor, interventions were planned to increase nursing staff confidence through in-service education. Pre-educational and post-education surveys were conducted, asking respondents a mix of quantitative and qualitative research questions. The Likert scale was employed to assess confidence levels. Survey respondents were asked to rate their confidence levels on five evidence-based positions for stage-one labor and five evidence-based positions for stage-two labor. Considerations for epidural, non-epidural, and bariatric (high BMI) patients were included. The education intervention consisted of handouts, posters, and in-person demonstrations, as well as the creation of a positioning tutorial video for future trainings. The results of this project demonstrate that overall confidence levels increased by 44.75% among all listed positions, and familiarity with the concept of sacrum flexibility in maternal positioning increased by 51.1%. Despite limitations in the project timeline and short staffing creating barriers to participation, this project demonstrated the effectiveness of in-service educational interventions in increasing staff confidence on maternal positioning.

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