OBJECTIVE: To describe the type and quantity of interventions provided to women in the first stage of labor. DESIGN: Descriptive, observational. SETTING: An intrapartum nursing unit in a Pacific Northwest medical center. PARTICIPANTS: Participants were 24 registered nurses employed on the intrapartum nursing unit and 75 women in labor with singleton pregnancies at 36 weeks or more gestation. Seventy-five 2-hour episodes of care that included one registered nurse assigned to a woman in labor were the units of analysis. MAIN OUTCOME MEASURES: Observed surveillance, indirect care, and supportive care interventions recorded during the episode of care during the first stage of labor. RESULTS: Nurses spent an average of 58.9% of the observed time in direct or indirect care of the study patient and provided an average of 169.9 interventions. Nurses spent 31.5% of the observed time providing at least one supportive care intervention with or without a simultaneous surveillance and/or indirect care intervention. CONCLUSION: Nurses provided supportive care more frequently than previous work sampling studies have suggested. This supportive care was frequently done in conjunction with other, more technical nursing care interventions. Integration of supportive care with other direct and indirect care interventions may offer the best model for providing high-quality intrapartum nursing care.
