Effectiveness Of Structured Cardiotocography Training On Maternity Nurses’ Performance And Fetal Trace Interpretation Competency: A Quasi-Experimental Controlled Study

Abstract

Background: Cardiotocography (CTG) is an essential method for intrapartum fetal monitoring and early detection of fetal distress during labor. However, deficiencies in CTG interpretation and monitoring practices among maternity nurses remain a significant challenge that may compromise maternal and neonatal safety.

Aim: This study aimed to evaluate the effectiveness of structured cardiotocography training sessions on maternity nurses’ performance and fetal trace interpretation competency.

Methods: A quasi-experimental study with intervention and control groups was conducted at Al Thagher General Hospital, Saudi Arabia. A convenience sample of 64 maternity nurses was recruited and equally assigned into intervention and control groups. Data were collected using a CTG Procedure Observational Checklist and a Fetal Trace Interpretation Tool. Assessments were conducted at baseline, immediately after the intervention, and at three-month follow-up. Data were analyzed using descriptive statistics, Chi-square tests, independent samples t-tests, mixed repeated measures ANOVA, Bonferroni post hoc analysis, Pearson correlation, and multiple regression analysis.

Results: The findings demonstrated statistically significant improvements among nurses in the intervention group across all CTG competency domains compared with the control group. Overall CTG competency scores increased from 5.43 ± 2.11 at baseline to 7.81 ± 1.28 during follow-up (p < .001). Fetal trace interpretation scores improved significantly from 6.34 ± 1.88 to 8.72 ± 0.58 (p < .001). Significant improvements were also observed in preparation-stage, performance-stage, and post-procedure CTG practices. The control group demonstrated no statistically significant changes across study phases.

Conclusion: Structured CTG educational interventions significantly improved maternity nurses’ practical performance and fetal trace interpretation competency, with sustained improvement observed after three months. Implementing competency-based CTG training programs may contribute to safer intrapartum monitoring and improved maternal–neonatal outcomes.