Safe and Effective IV Oxytocin Titration for Induction of Labor

Background: In 2023 33.2% of births in the United States involved an induction of labor (Ostermann et al., 20205) Local Problem: In 2025 at Prentice Women’s Hospital for 2025, the Induction of Labor rate was 43%. The policy for oxytocin titration provides a range of 30-60minutes for oxytocin to reach a level of 6mu/min. A chart audit and preliminary data analysis of 3 months showed the overall mean time to reach 6mu/min of oxytocin was 107.8-111.5 minutes. A previous study from 2020 analyzing IOLs at this institution also had similar mean times to get to 6mu/min. Methods: The American Society for Quality (ASQ) structure of Define Measure Analyze Improve Control (DMAIC) was used for this project to close the gap between the local hospital performance and align oxytocin titration with the policy. The aim of this quality improvement project was to align mean time oxytocin reaches 6mu/min in 30-60min and to 10mu/min in 60-120 minutes in accordance with current oxytocin titration policy (in the absence of s/s fetal distress) Interventions: Survey RNs to identify barriers to safe and effective oxytocin titration for induction of labor and provide evidence-based education on pharmacokinetics of oxytocin titration. Pilot a quick start oxytocin policy Results: Preliminary theme from RN barrier survey is busy with other patient care and unable to titrate in the appropriate window of time. Data on oxytocin titration analyzed monthly from April 2025 to February 2026. The mean time to get to 6mu/min of oxytocin ranged from 106.99 to 114.01 minutes. After a quick start policy is implemented, data times will trend toward the goal to align the mean time to 6mu/min with the policy range of 30-60minutes. Conclusions: This project analyzed oxytocin titration data for one year, despite RN education and identification of barriers the mean time to reach 6mu/min continued to be above the policies expected range. Through support of OB Quality Committee, the control for the project was the creation and implementation of a quick start oxytocin policy.