Agresti-Capstone Project Change Proposal Presentation for Faculty Review.docx

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Michele Agresti NRS-493: Professional Capstone and Practicum Capstone Project Change Proposal Presentation for Faculty Review Intervention It is suggested that women in labor change positions frequently. With an epidural you are limited in the number of different positions you can try because patients are mostly confined to their hospital bed. One tool that can help us is a peanut ball. A peanut ball is similar to an exercise/birthing ball, but it is shaped like a peanut shell. It is beneficial to patients laboring with epidural anesthesia or those restricted to the bed during labor (Stulz et al., 2018). There are different sizes available and the size chosen is based on the patient’s height. While the patient is resting in bed, lying on her side, sitting or semi-sitting the peanut ball can be placed in between the legs, or under one leg. The peanut ball encourages frequent position changes and promotes spinal flexion increasing the diameter of the pelvic outlet. This supports the natural labor progress by allowing more room for the fetus to descend (Tussey et al., 2015). Additional benefits include “ increased maternal-fetal circulation, decreased pain, improved quality of uterine contractions, facilitation of fetal descent and decreased length of labour” (Stulz et al., 2018). With the combination of increased pelvic diameter and frequent position changes, women who labored using the peanut ball had 50% less cesarean sections and decreased time spent in the first and second stages of labor (Hickey & Savage, 2019). The most effective positions are viewed in the appendix below. Evidence-based literature Inductions of labor are becoming increasingly more common, so much that a quarter of all pregnant women have their labor induced (Marconi, 2019). A labor that is lengthy and prolonged is associated with an increase in maternal and neonatal complications (Grenvik et al., 2019). A labor that fails to progress is the most common indication for an unplanned cesarean (Tussey et al., 2015). Cesarean sections create a financial burden on families. This financial burden is complicated by increased time off work to heal, longer hospital admissions and increased cost associated with cesarean section, especially when it follows a prolonged labor, and infection. On average, commercial and Medicaid insurers pay 50% more for C-sections than for vaginal deliveries” (Rodriguez, 2019). In the United States, greater than 90% of women who have a primary cesarean section will require a repeat in subsequent pregnancies (Tussey et al., 2015). With a rising rate of medical induction and the rising primary cesarean rate, it is imperative to place focus on the induction process. In the United States, epidural anesthesia is the most common type of pain relief used during childbirth (ACOG, 2021). While the epidural is effective for pain relief, it limits the mother’s mobility. This can negatively influence the length of labor in

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