Post on 16-Jun-2018
transcript
Objectives
• Participantswillbeabletoidentify2waystosupportwomeninlabor• Participantswilldemonstrateincreasedawarenessofthebarrierstolowmedicalinterventioninalowriskbirth• ParticipantswillexaminetheAWHONNpositionstatement:NursingSupportofLaboringWomen
InformedRefusal
• Theresponsibilityofthemedicalprovider
• Supportstheprincipleofautonomy• Patientunderstandswhatsheis
consentingto,andthepersonsandproceduretotakeplacearedetailed
• Physician/APRNmustexplainandensureunderstandingoftheprocedure,thebenefitsandrisks,whytheybelievesitisnecessary,alternativesandtheconsequencesofrefusal
• Avalidconsentisnotobtainedthroughfraud,forceorundueinfluence
Dobirthplansmakeadifference?• Womenwhoaremoreconfidentgoingintobirthhavebetterbirthexperiences
• Birthexperienceshaveasignificantinfluenceonamother'sself-esteemandhowsheviewsherbaby
• Asenseofcontrolisimportanttowomeninlabor
• Birthplanssignificantlyincreasebirthexperiencesatisfaction
• Recommendedforawomantobringabirthplanorcreateoneuponadmissiontothehospitalusingastandardtemplate
TheNurse’sRoleinlabor
• Assessmentandmanagementofthephysiologicandpsychologicalprocessesoflabor
• Facilitationofnormalphysiologicprocesses,suchasthewomen’sdesireformovementinlabor
• Provisionofphysicalcomfortmeasures,emotionalandinformationalsupportandadvocacy
• Evaluationoffetalwell-beingduringlabor• Instructionregardingthelaborprocess• Rolemodelingtofacilitatefamily
participationduringlaborandbirth• Directcollaborationwithothermembersof
thehealthcareteamtocoordinatepatientcare
NursingSupportofWomeninLabor• Shorterlabor
• Decreaseduseofanalgesia/anesthesia
• Decreasedoperativevaginalbirthsorcesareanbirths
• Decreasedneedforoxytocin/uterotonics
• Increasedlikelihoodofbreastfeeding
• Increasedsatisfactionwiththechildbirthexperience
PeanutBalls
• Shortensfirststageoflaborinprimiparouswomen
• Reducethelengthoflabor by90minduringthefirststageoflaborand22minduringthesecondstageoflabor(withepidural)
• Improvespatientsatisfaction• ReducedCesareanratesby13%inonestudy• Inexpensive• Adjustable
Sizematters
• 70cm• forsittingnotside-lying
• 60cm• Tallorplussizedwomen
• 50cm• Averagesizedwomen
• 40cm• Petiteorshortlegs
PeanutBallPositions• SideLying• TuckPosition• Semi- sittingLunge• FireHydrant• ForwardLeaning• Straddling• Pushing• Increasespelvicoutletcomparedtostirrup• Lessriskofnerveinjurythanwithstirrup
HypnosisforBirth
• Alteredstateofconsciousness• Awareofsurroundings• Usedforpainmanagementinotherspecialties• Usedbynurseseveryday
Hypno-tipsfornurses• Createandmaintaincomfortableenvironment
• Adopthypno-language(pressurewave=contraction)
• Protectmotherduringpressurewavefrominterruptionsorquestions
• Teamupwithbirthpartnerand/ordoula
Adviceforadministrators• Staffonenurseforeverylaboringmother• WritepoliciesthatreflecttheAWHONN
EFMguidelinesforintermittentmonitoring
• Promotetheuseofbirthplans• Providelabortoolssuchaspeanutballs• Createasupportiveenvironmentfor
doulastofeelwelcomeatthebedside• Provideeducationfornursesonlabor
supporttechniques• Sendnursestoconferencessuchas
AWHONNtokeepuponbestpractices• Encouragenursestodevelop
complimentaryskillssuchastherapeutictouchormassagebyprovidingorreimbursingforclasses
References
AWHONN.(2011).NursingSupportofLaboringWomen.JOGINN,40,665-666.DOI:10.111/j.1552-6909.2011.01288.x
Anderson,C.J.,&Kilpatrick,C.(2012).Supportingpatients'birthplans. NursingFor Women'sHealth,16(3),210-218.doi:10.1111/j.1751-486X.2012.01732.x
Attanasio,L.,McPherson,M.,&Kozhimannil,K.(2014).PositivechildbirthexperiencesinUS hospitals:Amixedmethodsanalysis.Maternal&ChildHealthJournal,
18(5),1280-1290.doi:10.1007/s10995-013-1363-1
Budin,W.(2015).ChoosingWiselyforBirth.JPerinatEduc TheJournalofPerinatalEducation,3-5.
Burgess,A.(2014).Anevolutionaryconceptanalysisoflaborsupport.InternationalJournalofChildbirthEducation,29(2),64-72.
Condra,T.,&Hafendorfer,L.(2011).InspiringandLeadingWomentoSucceedatUnmedicated Childbirth.JournalofObstetric,Gynecologic,&NeonatalNursing.
Harris,S.,Janssen,P.,Saxell,L.,Carty,E.,Macrae,G.,&Petersen,K.(2012).Effectofacollaborativeinterdisciplinarymaternitycareprogramonperinataloutcomes.CanadianMedicalAssociationJournal,1885-1892.
Meyer,S.(2013).Controlinchildbirth:aconceptanalysisandsynthesis.Journal
OfAdvancedNursing,69(1),218-228.doi:10.1111/j.1365-2648.2012.06051.x
Reisz,S.,Jacobvitz,D.,&George,C.(2015).Birthandmotherhood:childbirthexperienceandmothers'perceptionsofthemselvesandtheirbabies.InfantMentalHealth
Journal,36(2),167.doi:10.1002/imhj.21500
Xue,Y(2013).InformedConsent:Hospital.JoannaBriggsInstitute. Farahat,A.H.,Mohamed,H.S.,Elkader,S.A.,&El-Nemer,A.(2015).Effectof
implementing abirthplanonwomens'childbirthexperiencesandmaternal&neonataloutcomes.Journal ofEducationAndPractice,6(6),24-31.
WebsiteResources
• www.perinatalempowerment.com• www.premierbirthtools.com• www.spinningbabies.com• www.hypnobabies.com• http://www.babycentre.co.uk/a1038554/aromatherapy-in-pregnancy• http://www.therapeutictouchontario.org/index.php/therapeutic-touch/what-is-therapeutic-touch• http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Approaches-to-Limit-Intervention-During-Labor-and-Birth