Comment1

In labor & delivery we have recently adopted a research-based or evidence-based practice, which is the use of the Peanut Ball during labor. It is a tool used for promoting the progress of labor, by facilitating normal fetal descent (bringing the baby down) for an easier delivery, and to prevent the patient from having to have a primary C-section. Failure to progress during labor is the most common indication for a first time C-section (Tussey, et al., 2015). Before last year, my hospital had let the mother labor down on their own without any assistance, other than letting the patient reposition themselves in bed as needed. Needless to say the hospital primary C-section rate was high and needed to be lowered. According to, Reducing Length of Labor and Cesarean Surgery Rate Using a Peanut Ball for Women Laboring With an Epidural 2015, “The ball promotes spinal flexion, increasing the uterospinal angle, and increasing the pelvic diameters to facilitate occiput posterior rotation, which results in a widened pelvic outlet.” Now, once the patient comes in and it has been established that she is in labor, we utilize the peanut ball on all patients by placing it between their legs to keep the pelvis open and rotating the patient from side to side to help shorten the length of labor and to help decease the primary C-section rate.

Comment 2

Evidence-based practice is utilized to promote quality, cost-effective outcomes for patients as well as the healthcare professionals and healthcare system (Burns & Grove, 2011). Evidence-based practice is the action of implementing best evidence-based care, supported by research, and integrating the care with patient’s needs and values as well as clinical expertise (Burns & Grove, 2011). Nurses utilizing evidence-based care began as the profession began. Florence Nightingale realized that cleanliness to air, water and diet promoted health to her wounded soldiers and aided in their recovery (Burns & Grove, 2011).  Examples of evidence-based practice include better management of patient’s blood pressure on a primary care level to better avoid heart attack, stroke and kidney disease, as well as understanding risks factors for diabetes leading to earlier screening for patients who possess the risk factors, or the appropriate guidelines for IM medication administration to promote effectiveness of medication delivery and patient’s comfort (Burns & Grove, 2011). In Singapore, 64% nurses expressed positive attitude towards evidence based practice and bettering their patient’s outcomes, however also expressed concern on their already heavy workload while attempting to keep up with data and new evidence (Majid & et. al, 2011). The main barriers in implementing evidence-based care to this facility in Singapore was found to be lack of time, lack of ability to understand the statistical data as well as jargon used in the research articles (Majid & et. al, 2011).

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