Institutional Factors Influencing Student Performance in Management of Second Stage of Labour in Kakamega County Hospitals, Kenya

Context: The second stage of labour is a critical phase of childbirth, during which the mother is required to push the baby through the birth canal. Institutions have a key role in supporting student learning. Institutional factors encompass all factors that affect the performance of nursing students both at the training institution and at the clinical site. Information derived from data will be used to decide how to improve clinical learning in labour wards. Aim: The study's precise goal was to assess institutional factors influencing student performance in managing the second stage of labour in Kakamega County hospitals, Kenya. Methods: The study employed an analytical cross-sectional research design using a quantitative data collection approach. The study area was limited to labour wards of hospitals in Kakamega County that receive student nurses for clinical placement. The study population comprised 175 nursing students. Systematic sampling was used to select study participants. Data collection included interviewer-administered questionnaires and a student performance observation checklist to assess the student performance in managing the second stage of labor. Quantitative data analysis techniques included descriptive and inferential statistics. Results: Multiple regression was applied for inferential statistics, with a p-value of ≤0.05 considered statistically significant. Students in placement sites who reported having an easy time working with patients were 2.5 more likely to have had outstanding performance (OR: 2.5; 95% CI: 1.0–6.0; p=0.04), the association being statistically significant. Equally, those in placement sites with equipment in good condition were 2.3 times more likely to have reported outstanding performance (OR: 2.3; 95% CI: 1.1–4.7; p=0.02). In the same way, students who agreed that they could use the equipment with ease revealed statistically significant results compared to those who disagreed (OR: 2.3; 95% CI: 1.1–4.9; p=0.03). On support and guidance, students who agreed that they were guided by qualified staff when performing practical procedures were likely to have done better (OR: 0.4; 95% CI: 0.1–0.9; p=0.02). Conclusion: Institutional factors play a bigger role in successful student performance, particularly time spent working with patients, an equipped placement site, the ability to easily use equipment, and guidance by qualified staff. The study recommends training institutions and placement sites to provide adequate resources, including staff and clinical instructors.