Document Type

DNP - Open Access

Award Date


Degree Name

Doctor of Nursing Practice (DNP)


Graduate Nursing

First Advisor

Brandi Pravecek

Second Advisor

Cynthia Elverson


Background: Nationwide focus has been placed on the reduction of incidence of adverse maternal and neonatal outcomes in nulliparous, term, singleton, vertex (NTSV) patients.
Local Problem: Nursing leaders of a maternal child health unit in the upper Midwest recognized a need to reduce the rate of adverse maternal outcomes with evidence-based practice. The facility does not currently have an induction of labor (IOL) protocol.
Methods: The California Maternal Quality Care Collaboration Toolkit to Support Vaginal Birth and Reduce Primary Cesarean Sections was used to create an IOL protocol to prevent adverse maternal outcomes. Categorical outcome data was compared for 6 months pre-post implementation.
Intervention: Educational forms were used to guide the scheduling of IOL, patient education regarding IOL, and a Bishop score sheet and create awareness for both physicians and nurses when scheduling, admitting, and caring for the NTSV induced patient.
Results: A decreased number of adverse maternal outcomes were noted, however statistical significance was not achieved. No conclusion can be made regarding the IOL protocol and the outcomes variables.
Conclusion: Hospital-level quality improvement projects, when used with interdisciplinary collaboration, may positively influence maternal outcomes, and improve overall patient care and healthcare spending.


South Dakota State University


Copyright © 2024 Rebecca Erickson

Available for download on Thursday, May 15, 2025