Level of Nursing Experience and its Link to Cesarean Birth Rate [20O

Abstract

INTRODUCTION: High cesarean birth rates are a concern both in the United States and around the world. There is limited research on the role of nursing care in contributing to cesarean births in patients who have the potential to deliver vaginally. Our study investigated an association between level of nursing experience and risk of cesarean birth by analyzing an existing data set. METHODS: We obtained a sample of women giving birth at a community hospital in New Jersey with approximately 6,000 births per year. Data were extracted from records of every eligible birth over a 2-month period, including experience of the nurse providing care, maternal and infant characteristics, obstetrical procedures, and type of birth. Pregnant patients were selected based on inclusion criteria: ages 18-40 years old, carrying singletons, at 37 weeks or more. Exclusion criteria included: prior uterine surgery, prior cesarean, and planned cesarean. After controlling for maternal age, race, body mass index, parity, infant weight, gestational age, type of rupture, and epidural analgesia, the association between cesarean birth and years of nursing experience was analyzed by a chi-square test. Total amount and maximum rates of Pitocin administered were compared with nurse experience by a Student t-test. RESULTS: Associations between nursing experience and cesarean section rate, total amount of Pitocin administered, and maximum Pitocin rate administered during labor were found with statistical significance (P<.05). CONCLUSION: Based on these results, this study concludes that more experienced nurses have higher cesarean section rates, and administer lower total amounts and lower maximum rates of Pitocin during labor.