First Advisor

Dr. Carol Wallman

Second Advisor

Dr. Julie Javernick

Thesis Committee Member(s)

Dr. Wallman, Dr. Cullen, Dr. Kruschke, Dr. Witt, Dr. Claywell, Dr. Wang


Dr. Wallman


Rueckert-Hartman College for Health Professions

Degree Name

Doctor of Nursing Practice



Document Type

Thesis - Open Access

Number of Pages

69 pages



The purpose of this quality improvement project is to safely reduce early labor admission rates through the implementation of evidence-based nursing triage management protocol focused on patient education and labor support for spontaneous early labor management in a community hospital setting. This initiative is part of a bundle of care intended to safely reduce primary cesarean birth rates.


A paired sample t-test was used to compare the following: early admission rates of NTSV patients before and after the study intervention: a pre and post knowledge survey taken by labor and delivery nurses; pre and post ELEQ survey results taken by postpartum patients prior to discharge.


Strategies implemented in this project did not positively impact early admission rates which slightly increased from 9% to 11%; mean score decreased from 1.84 to 1.76 (p.322). Overall, the total aggregate score of staff knowledge related to care of this patient population increased slightly from 4.03 to 4.09 (p 0.438). Nurse willingness to implement new techniques and provide patient education in early labor increased: staff confidence with the new techniques declined. The overall ELEQ mean score increased from 2.68 to 3.05, an increase of 7.4%. Mean scores for 24 of 26 questions increased.


This early labor management project had mixed results; while early labor admission rates did not decrease, the interventions enhanced nurse involvement in early labor support. There was also an overwhelming increase in patient satisfaction scores related to their early labor experience.

Date of Award

Spring 2022

Location (Creation)

Colorado (state); Denver (county); Denver (inhabited place)

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