BWH Nurses Join International Study of Early Labor
Carol Jean Luppi, RNC, BSN, clinical educator for the Center for Labor and Birth, will serve as the site coordinator for BWH, and Carolyn Hayes, PhD, RN, nurse researcher for The Center for Excellence in Nursing Practice, will support the group.
BWH has been designated as an international study site by the University of Toronto for Structured Early Labor Assessment and Care by Nurses (SELAN). The multi-center trial aims to rigorously evaluate the effectiveness of a structured approach to pre- and latent- phase labor care by nurses and to compare the cost of the structured approach with that of traditional care.
Traditional nursing care during early labor is based on the belief that women do best when they are not admitted to the labor and delivery unit until labor becomes more active (cervix dilated at least 3 cm). The structured nursing care in this study is based on the belief that specific techniques to help with mal-positioned fetus and high maternal anxiety—two common problems in early labor—are useful.
These problems are associated with an increased number of labor complications and a higher risk of operative births. Therefore, in addition to traditional nursing care, the study nurses will assess babies’ positions in-utero, and the women’s thoughts and feelings during early labor. The nurses will then provide advice to the woman based upon these assessments.
The nurses will suggest maternal position changes that facilitate fetal rotation to a more optimal position. They also will attempt to decrease the woman’s stress response through continuous presence, reassurance, comfort measures, information/ advice, anticipatory guidance, re-framing distress and normalizing the environment. Carol Jean Luppi, RNC, BSN, clinical educator for the Center for Labor and Birth, will serve as the site coordinator for BWH, and Carolyn Hayes, PhD, RN, nurse researcher for The Center for Excellence in Nursing Practice, will support the group. The study is funded by the Canadian Institutes of Health Research. Participant recruitment will begin on May 1, 2003.