Effect of Implementing Nursing Care Bundle upon Perineal Trauma Reduction and Birth Outcomes during Vaginal Birth

Perineal trauma may negatively affect a woman's life, leads to short- and long-term maternal morbidities. Care bundle is now a common approach to improve the care quality and patient outcome over the past decade. It serves as a method of motivating health professionals to act in accordance with accepted best practices that can be implemented consistently and collectively to a unique patient during a clinical episode. The study aim: Evaluate the effect of implementing nursing care bundle upon perineal trauma reduction and birth outcomes during vaginal birth. Subjects and Method: A Quasi-experimental research design was used. Subjects: A purposive sample of 130 women has been selected from antenatal clinics and labor units of obstetrics departments at; Tanta University Hospital, El-Mobara and El-Menshawy General Hospital. Four tools were utilized: Tool (I): Women' Labor Parameters Assessment Sheet. Tool (II): Birth Outcome Assessment sheet. Tool (III): Perineal trauma Observational Checklist. Tool IV: Visual Analogue Scale (VAS). Results: After application of the nursing care bundle, a significant reduction of perineal trauma/ tears and pain as well as maternal and newborn complications was documented among the nursing care bundle group in contrast to the routine hospital care group. Conclusion: The nursing care bundle implementation comprising evidence-based interventions performed collectively was effective in reducing perineal trauma and pain as well as improving birth outcomes. Recommendations: The nursing care bundle application must be integrated in nursing education and ongoing in-service training programs for maternity nurses.