Effectiveness of staged nursing in reducing labor analgesia complications: a retrospective cohort study

TL;DR

Staged nursing during labor reduces complications from pain relief and improves maternal satisfaction compared to standard care.

Contribution

This study demonstrates that staged nursing reduces analgesia-related complications and improves outcomes in labor.

Findings

Staged nursing reduced hypotension, respiratory depression, and post-dural puncture headache rates.

Maternal satisfaction was higher with staged nursing, and labor duration and analgesia dosage were lower.

The results suggest structured nursing protocols can enhance maternal safety during labor.

Abstract

The rising incidence of complications linked to labor analgesia underscores the need for targeted strategies to improve maternal outcomes. Staged nursing, a tiered approach to assessment and care, has been proposed to enhance safety and reduce adverse events during labor.

This study aimed to evaluate whether staged nursing care is more effective than standard nursing in reducing the complications associated with labor analgesia.

This retrospective cohort study included 278 women who received either standard nursing care or staged nursing care during labor between January 2018 and December 2021 at a tertiary care hospital. Staged nursing involved structured assessments, continuous monitoring, and individualized interventions. The primary outcomes were the incidence of analgesia-related complications. Secondary outcomes included labor duration, analgesia dosage, and maternal satisfaction.

The staged nursing group showed significantly lower rates of hypotension (8.6% vs. 18.0%, p = 0.03), respiratory depression (2.2% vs. 7.9%, p = 0.04), inadequate pain control (6.5% vs. 16.5%, p = 0.01), and post-dural puncture headache (2.9% vs. 10.1%, p = 0.02) than the control group. Satisfaction scores were higher in the intervention group (4.3 vs. 3.5, p < 0.001), and both labor duration and analgesia dosage were significantly reduced.

Staged nursing effectively reduces complications and improves maternal satisfaction during labor. These findings suggest that structured nursing protocols can enhance maternal safety and should be considered for integration into routine obstetric care.

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