ORIGINAL RESEARCH article
Front. Glob. Women’s Health
Sec. Maternal Health
Impact of Integrating Responsibility System Management with Preventive Nursing on Post-Cesarean Recovery and Infection Outcomes
Provisionally accepted
- 1The Fourth Hospital of Shijiazhuang, Shijiazhuang, China
- 2Handan Second Hospital, Handan, China
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Background: Cesarean section (CS) rates continue to rise globally, accompanied by increased risks of postoperative complications, particularly infections and delayed recovery. Conventional nursing models often lack accountability and structured preventive measures, limiting their effectiveness in improving perioperative outcomes. This study aimed to evaluate whether integrating responsibility system management with preventive nursing could reduce postoperative infections and enhance recovery after CS. Methods: A single-center, prospective cohort study was conducted, enrolling 200 women scheduled for elective CS. Participants were categorized into a cohort exposed to an integrated care model (responsibility-based management combined with preventive nursing) and a cohort managed with routine care. The primary outcome was the incidence of postoperative infection within 30 days. Secondary outcomes included recovery indicators (time to ambulation, flatus, incision healing, hospital stay), pain score at 24 hours, and patient satisfaction. Data were analyzed using t tests, χ² tests, logistic regression, Cox models, and ROC curve analysis. Results: Baseline characteristics were comparable between groups. The intervention group exhibited a significantly lower infection rate compared with controls (5.0% vs. 13.0%, P = 0.046). Recovery outcomes were also improved: earlier ambulation (21.86 ± 4.28 vs. 26.30 ± 5.24 h), shorter time to flatus (30.45 ± 5.67 vs. 34.82 ± 6.15 h), reduced hospital stay (5.42 ± 1.02 vs. 6.09 ± 1.14 days), and lower pain scores (3.22 ± 0.81 vs. 3.80 ± 0.89; all P < 0.001). Nursing satisfaction was higher in the intervention group (96.0% vs. 85.0%, P = 0.018). Kaplan-Meier analysis confirmed a significantly higher infection-free survival rate in the intervention group (Log-rank P = 0.032). Multivariate analysis showed the intervention reduced infection risk (HR = 0.42, 95% CI: 0.18–0.95). Adding the intervention to the predictive model improved discrimination (AUC: 0.85 vs. 0.71, P = 0.008). Conclusion: Integrating responsibility system management with preventive nursing significantly decreases postoperative infection risk, accelerates recovery, and improves patient satisfaction among CS patients. This combined strategy is safe, effective, and holds promise for broader clinical application.
Keywords: Cesarean Section, responsibility system management, preventive nursing, Postoperative infection, Recovery outcomes
Received: 02 Sep 2025; Accepted: 04 Nov 2025.
Copyright: © 2025 Yan, Xuehua and Huan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Sun Xuehua, tanleileisjnk@163.com
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