SUPPORTIVE CARE BY MATERNITY NURSES - A WORK SAMPLING STUDY IN AN INTRAPARTUM UNIT

Background: This word sampling study examined how much time intrapartu m unit nurses spend providing supportive care overall and during weekd ay and weekend shifts, and by patient and staff characteristics at a u niversity hospital with 400 births per year in Montreal, Quebec. Metho ds: Four-hour observation periods were randomly selected to represent each shift and day of the week. Within each period, eight 15-minute ob servation times were randomly selected. Observers located each nurse a ssigned to the unit at that time and recorded her activity. Supportive activities included physical comfort, emotional support, instruction, and advocacy. Results: The percentage of time spent in supportive car e was 6.1 percent (95% confidence interval 5.3%, 6.9%), based on 3367 observations. The time providing supportive care was similar for weekd ay and weekend shifts. Nurses with less than seven years of intrapartu m experience spent 2.7 (0.9, 4.5) more time providing supportive care than nurses with seven years of experience or more. Supportive care wa s 9.2 percent (0.7, 17.7) greater for nulliparous than for parous wome n, and supportive care of women with epidural anesthesia was similar t o those without it. Conclusions: We concluded that intrapartum unit nu rses spent a small amount of time providing supportive care to women i n labor. This suggests the need for perinatal caregivers and hospital administrators to reexamine how nurses spend their time, given the evi dence from randomized trials showing the beneficial effects of continu ous support on labor and birth outcomes.