Use of a Peanut Birthing Ball During Labor
Use of a Peanut Birthing Ball During Labor by Suzette Arrindell, MSN, RNC-OB
PICO(T) QUESTION • In laboring women, how does the use of a peanut ball, compared with not using a peanut ball, effect the length of first stage labor and the incidence of cesarean delivery?
PICO • Patient population: for pain • Intervention: • Comparator: birthing • Outcome: Laboring mothers, specifically with an epidural management The use of a peanut birthing ball Laboring mothers who do not utilize peanut ball Shorter duration of labor and decrease in primary cesarean sections
GAP analysis • First stage of labor encompasses the onset of active labor to complete cervical dilation • Longer duration of labor is associated with increase risk of cesarean section • Repeat cesarean section deliveries account for highest number of cesarean births • Epidural anesthesia results in limited mobility, which contributes to longer duration of labor
Evidence for intervention • Peanut balls open the maternal pelvis, aiding in rotation and descent of the fetus (Roth, Dent, Parfit, Hering, & Bay, 2016). • Women receiving epidural anesthesia are frequently in a modifiedsupine position, making the use of a peanut ball beneficial (Payton, 2015). • Use of a peanut ball has been shown to decrease the length of both first and second stage labor and decrease the incidence of cesarean section delivery (Tussey, Botsios, Gerkin, Kelly, Gamez, & Mensik, 2015).
SWOT analysis (Reavy, 2016) Strengths Environment that encourages change The exceptionally low cost of the equipment needed Non-invasive and nonpharmaceutical Opportunities Shorter laboring hours Lower cesarean section rates Opportunity to increase patient satisfaction Weaknesses Patient resistant to awkward position Repositioning every 20 -60 minutes unappealing Threats More experienced nurses’ resistant to change Physician buy-in
Projected budget Budget for materials Budget for staff time Total projected cost Four peanut birthing balls at $40. 00 each $160. 00 Materials for posters and collection tool $100. 00 One hour needed for presentation and training for 35 nurses $1, 400. 00 (based on an average hourly salary of $40. 00/hour $1, 660. 00
Project leader • The presenter of this presentation is the most qualified to lead this project based on the following set of skills and experience: • 14 years of experience as a Labor and Delivery nurse • Over one year spent providing the research on the need for the projected project • Experience with previous successful change projects lead by the presenter • Willingness to facilitate the project from beginning to the culmination
Positions needed (Roles in change management, 2017) • Project leader • • • Authorize funding for project Unit manager • • Go-to person during the length of project Senior manager • • Develop plans for project Guides and support project team Project team • Labor and delivery staff nurses to implement project • • Provide feedback on collection tool Project support team • Experienced staff nurses • Provide additional guidance and support throughout project process
References • Payton, C. (2015). Use of a peanut ball to decrease first and second stages of labor. Graduate thesis, dissertations, and capstones, paper 14. Retrieved from http: //scholarworks. bellarmine. edu/cgi/viewcontent. cgi? article=1013&context=tdc • Reavy, K. (2016). Inquiry and leadership: A resource for the DNP project. Philadelphia, PA: F. A. Davis Company • Roles in change management. (2017). Retrieved from https: //www. prosci. com/changemanagement/thought-leadership-library/roles-in-change-management • Roth, C. , Dent, S. , Parfit, S. , Hering, S. , & Bay, R. (2016). Use of the peanut ball during labor. American journal of maternal child nursing, 41(3), 140– 146. doi: 10. 1097/NMC. 0000000232 • Tussey, C. , Botsios, E. , Gerkin, R. , Kelly, L. , Gamez, J. , & Mensik, J. (2015). Reducing length of labor and cesarean surgery rate using a peanut ball for women laboring with an epidural. Journal for perinatal education, 24(1), 16 -24. doi: 10. 1891/1058 -1243. 24. 1. 16
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