Initiating Evidence Based Practices

Specialties Ob/Gyn

Published

Nursing student here, waiting for my car to be serviced and I was wondering:

What evidence based practice/new practices have you tried to introduce in your unit? Say for example: uninterrupted skin to skin, delayed bath, skin to skin in the OR, peanut balls, sterile saline injections for back labor, nitrous oxide, induction recommendations/guidelines, VBAC, etc. Were you successful, why or why not?

No this is not homework. I am a reawaken trained doula, ICAN chapter leader, with the goal of being an L&D nurse when I graduate. I know the hospitals in my area are not all that progressive and I'm wondering AFTER I get settled as a new nurse, how could I effect positive change if needed.

Up Vote Up Vote ×

You sound fabulous! I am a doula trained through to labor. Has my BSN. Couldn't land a job in L&D until about a year after grad and it was as homebirth RN assisting a CNM. That has been super awesome but too unpredictable and now need steady income. Just got hired yesterday on a unit that does 4000 deliveries yesterday. Nurse manager said that she thought it was crazy hard to implement evidence based policies because people are creatures of habit and ultimately the providers have to change themselves. There is something at my new institution called a clinical ladder. You can get raises for designing evidence based policies. Ultimately, folks such as ourselves have to get into facilities and do our best to make it into places of leadership and management, in order for things to change hospital protocol wise. The patients are the biggest deciding factor though in my opinion. They need to pick providers who are truly game to honor their wishes. They need to print out stuff from evidence based birth . Com and share with their provider and their friends. The good fight is going to be a long one, and it is so worth it! Good luck, kindred spirit!

Up Vote Up Vote ×
You sound fabulous! I am a doula trained through to labor. Has my BSN. Couldn't land a job in L&D until about a year after grad and it was as homebirth RN assisting a CNM. That has been super awesome but too unpredictable and now need steady income. Just got hired yesterday on a unit that does 4000 deliveries yesterday. Nurse manager said that she thought it was crazy hard to implement evidence based policies because people are creatures of habit and ultimately the providers have to change themselves. There is something at my new institution called a clinical ladder. You can get raises for designing evidence based policies. Ultimately, folks such as ourselves have to get into facilities and do our best to make it into places of leadership and management, in order for things to change hospital protocol wise. The patients are the biggest deciding factor though in my opinion. They need to pick providers who are truly game to honor their wishes. They need to print out stuff from evidence based birth . Com and share with their provider and their friends. The good fight is going to be a long one, and it is so worth it! Good luck, kindred spirit!

Thank you! I absolutely LOVE evidence based birth. She tears things apart to the core!

Congratulations on your new job! Best of luck!

(also I am A DONA trained doula, I have no idea how that got changed to reawaken?!)

Up Vote Up Vote ×
Specializes in Labor and Delivery.

Last year my unit implemented skin to skin in the OR as evidence-based and last month we started using Peanut Balls! So far I have used them several times on my patients with epidurals (mix between multips and primips) and they worked every one of those times (sped up the labor process and allowed those babies to come down nicely)! I will continue to recommend them! One of our nurses who is in CNM school recommended them and they took off with a success so far! I am going to try to introduce the Go Full Forty into our discharge paperwork to the labor evals we get. We will see what they say when I bring it up. :)

Up Vote Up Vote ×

AspiringNurseMW, I am sorry to hijack your thread, but I wanted to reach out to you and am new to this site and unsure how to send you a message privately. I live in Honesdale and my status on Webadvisor just changed to accepted for the 2016 nursing program! I previously apprenticed with a midwife and worked as a doula. I love everything pregnancy, birth, and baby related :) Anyway, you seem like you would be someone I would enjoy chatting with. My email is [email protected] if you would like to reach me. Wishing you all the best in your continued studies!

Up Vote Up Vote ×
Specializes in ED, Pedi Vasc access, Paramedic serving 6 towns.

Hi,

I am just wondering what Peanut balls are??!!

Annie

Up Vote Up Vote ×
Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

Unlike a regular labor ball/yoga ball, a peanut ball is more oval with a narrower part in the center (looks just like a peanut in the shell) which is safer and more comfortable to sit on.

Up Vote Up Vote ×
Specializes in Labor and Delivery.
Hi,

I am just wondering what Peanut balls are??!!

Annie

It works great with moms who have epidurals or are in bed for a period of time. Lay them on their side with the ball in between their legs and it gives them a good wide open pelvis. With the moms I've used them on that have had epidurals it has shortened their first and second stage of labor. Others have noticed that the peanut balls have reduced the rate of cesarean. So far I really like them and glad our unit has implemented their use.

Up Vote Up Vote ×
Specializes in Labor and Delivery.
Nursing student here, waiting for my car to be serviced and I was wondering:

What evidence based practice/new practices have you tried to introduce in your unit? Say for example: uninterrupted skin to skin, delayed bath, skin to skin in the OR, peanut balls, sterile saline injections for back labor, nitrous oxide, induction recommendations/guidelines, VBAC, etc. Were you successful, why or why not?

No this is not homework. I am a reawaken trained doula, ICAN chapter leader, with the goal of being an L&D nurse when I graduate. I know the hospitals in my area are not all that progressive and I'm wondering AFTER I get settled as a new nurse, how could I effect positive change if needed.

Oh, we also have implemented delayed bathing too, which makes me happy. So many benefits of this! Parents often ask if the baby will be bathed immediately and then we explain why we aren't doing that in the hospital anymore and they are very receptive. It's amazing how much education we are able to do.

Up Vote Up Vote ×
Specializes in Eventually Midwifery.

Maybe push for baby friendly accreditation? That will implement many of the things that you are talking about. https://www.babyfriendlyusa.org/

Up Vote Up Vote ×
Specializes in L&D, infusion, urology.

I *JUST* started on my unit, so I haven't yet implemented change, but I already see plenty of room for it. Delayed bathing, getting moms into positions other than lithotomy for pushing, getting baby on the breast ASAP, allowing for passive descent if baby is tolerating it well... The epidural rate at our hospital is something like 90% (I haven't seen a natural birth there yet, even when a mom arrived on the floor ready to push, we waited until she got an epidural, which benefitted her for MAYBE 10 minutes.

Once I have some time on the unit, I'd like to join a committee for implementing EBP. I know there ARE people working on this stuff already, trying to get the push for Baby Friendly going (they LOVE that I worked at a freestanding birth center that has been Baby Friendly since the 90s!) and advocating for the Full Forty and other EBPs. I love when I do have the chance to educate parents or encourage better practices. I had parents the other day that were debating whether or not to delay the bath, so I explained to them some of the pros and cons, and they ultimately decided to wait.

Now if I could just get them to stop routine circumcision... :eek:

Up Vote Up Vote ×
+ Add a Comment