| dc.description.abstract | The second stage of labor is a crucial period of childbirth in which the mother must use force
to propel the baby through the birth canal. The objective of this study was to evaluate the
proficiency of preservice nursing students in handling the second stage of labor. Specifically,
the study aims were; to measure the performance of student nurses in managing second stage
of labour, examine student characteristics and assess institutional factors impacting student
performance in management of second stage of labour. The study adopted analytical cross
sectional research design combining both quantitative and qualitative methodologies in data
collection. The study area was limited to maternity unit labour wards of hospitals in
Kakamega county that receive student nurses for clinical placement. The study population
composed of 175 nursing students and 8 clinical teachers coupled with ward supervisors.
Systematic sampling was utilized to choose study participants. Data collection includes
interviewer provided questionnaire, checklist for observing student performance in second
stage of labour and key informant interviews conducted with clinical teachers and ward
supervisors. Quantitative data analysis procedures included both descriptive and inferential
statistics while qualitative material was evaluated thematically guided by the study
objectives. For inferential statistics, multiple regression was employed, with a p value of ≤
0.05 considered as statistically significant. Results on knowledge assessment and its
relationship with performance in management of second stage of labour revealed that the
students had good knowledge in management of second stage of labour represented by
62.5%, however findings show they had inadequacy in infection prevention practices and
inability to make timely decisions represented by 41.7% and 31% respectively Results on
performance in management of second stage of labour revealed that 62.9% exceeded
expectation with 24.6% demonstrating remarkable performance. Assessment on the link
between self-confidence and performance was statistically significant (OR: 2.7; 95% CI: 1.2 – 5.6; p = 0.009). Those who reported health concerns as the cause for missing practicum
were 70% less likely to have posted outstanding achievement as compared to their
counterparts who never missed or gave other reasons (OR: 0.3; 95% CI: 0.1 – 1.0; p = 0.05).
Performance was good with participants being accurately able to prepare the mother properly
for second stage of labour and 80% of respondents were able to confirm second stage of
labour. Majority of the participants were not able to prepare all equipment for delivery
(72.6%). throughout performance stage ,90% of the participants were able to assist the
mother properly throughout second stage with 92.6% being able to support the perineum
accurately. 42.9% of participants replied that they often miss clinical sessions while seeking
for fee since they have to complete fee payment before being permitted to travel to clinical
area and that there is delay by the institutions in arranging clinical sites thereby affecting
length of clinical placement. Shortage of trained staff and clinical instructors to guide
students surfaced as another problem affecting performance as mentioned by 24% of
participants. Key informants indicated inadequate equipment and resources as the most
observed problem for students in the clinical area. In conclusion, student nurses did well in
management of second stage of labor yet they were less competent in infection prevention
procedures and in making prompt judgments. Key student criteria shown to influence
performance include abseentism relating fee payment to traveling to clinical area. On
institutional factors influencing student performance in managing second stage labour
included lack or inadequate equipment and commodities, time taken looking for clinical
sites, lack of clinical objectives and shortage of staffs/clinical instructors. The study
recommends training institutions and placement sites to provide adequate resources for
student nurses during clinical attachment and delink fee payment to going for clinical
placement | en_US |
