Here's Lookin’ at You Kid! Implementation of Individual Fetal Monitoring Strip Review Education


Poster Presentation

Purpose for the Program

Obstetric nurses are consistently provided with formal education on fetal monitoring. This didactic education ensures there is a foundation for excellence in the care that they give to the patient at the bedside. However, nurses may not be speaking the same language when they are interpreting, intervening, and communicating live fetal monitoring strips on their nursing units. It became clear that a process for evaluating individual nurses’ practice was needed. This type of education also allows for real time remediation and education regarding fetal monitor strips by the clinical nurse specialist and the clinical education specialist.

Proposed Change

To implement a process for evaluating and providing education regarding live interpretation, knowledge of necessary interventions, and appropriate communication of fetal monitor strips with individual nurses in a one-to-one setting. This process will help to ensure that there is consistency related to fetal monitoring by nursing staff.

Implementation, Outcomes, and Evaluation

The clinical nurse specialist and clinical education specialist developed a process for evaluating and providing education regarding fetal monitor strips with individual nurses. Nurses were privately asked 10 questions regarding their interpretation of live fetal monitor strips. They were then asked to provide an explanation of how they would intervene and communicate information about the strip. This process was repeated for three live tracings during their one-to-one education. The nurses were given follow-up remediation and education for any incorrect responses during the January 2012 and March 2012 sessions. Twenty-five nurses were blindly chosen and were scored with a Likert scale of 0 to 4 based on the number of correct responses during their one-to-one sessions in January 2012 and March 2012. The nurses were then retested in September 2012 without remediation or educational tools. The average score of the 25 nurses in January 2012 was 1.68/4. The average score in March 2012 of the same 25 nurses was 2.4/4. The average score in September 2012 was 3.65/4. The increase in average scores demonstrated a positive relationship between the one-to-one strip reviews and the nurses’ ability to consistently interpret the fetal monitor strips.

Implications for Nursing Practice

This process for evaluating and providing education for live fetal monitor strip interpretation to individual nurses can be implemented in any nursing care facility. It is essential that nurses not only complete formal education courses in fetal monitoring, but that they also are assessed regarding their knowledge and ability to intervene and communicate in live situations.