Nursing research

Please support your initial discussion and opinions with at least two citations from the assigned readings, and peer-reviewed professional nursing literature. 

See the Nursing Syllabus Standards & Policies Document for Discussion Participation Guidelines & Grading Criteria. 

Reflect upon your career as a nurse. Identify a topic in your practice that would benefit from evidence. You may use a recent change that has occurred and describe how the evidence impacted nursing practice. You may also describe a situation encountered in practice that is handled differently by each provider with varying results. 

answer of one of my classmate. I am a floor nurse and I administer medication and I do assessment as well. a topic will be to make sure that the patient eat before any medication.

Discussion 1, Question 1

My nursing career started with of year of practicing on a med-serg/tele unit. After that year, I transferred to labor and delivery, where I have remained for the past five years. My role as a labor and delivery RN includes various responsibilities and functions. I retrieve patients when they first arrive as a triage RN to establish their needs and level of acuity. As a bedside RN, I manage the care of mother and baby through the process of labor and delivery. As a transition RN, I am responsible for caring for the baby as it transitions to life earthside. I also function as a scrub RN for surgical procedures and can be floated to perinatal to care for hospitalized patients not ready for delivery.

A topic in my practice that would benefit from evidence is prohibiting patients admitted for labor from eating. Patients are placed on clear liquid diets, except for those that are NPO for other reasons. This includes every patient, even those not currently in labor admitted for an induction. An induction can last as long as three days, and the patients are not allowed to eat per anesthesia. If the patient requires a c-section with general anesthesia, the concerns pertain to aspiration. The patient’s risk factors or acuity are never considered. Both low and high-risk patients follow the same protocol. For years, the basis for this practice has not been supported by sufficient evidence (Phelps, Deavers, Seehusen, & Stevermer, 2018 ). Recently, there have been discussions regarding if this is the best practice for the patient and whether evidence supports this practice. According to Phelps, Deavers, Seehusen, and Stevermer (2018), "Dietary restrictions continue to be utilized in spite of the evidence that only about 5% of obstetric patients have a need for general anesthesia" (p. 379).

A practice that has changed over the last few years is the use of oxygen for intrauterine resuscitation. When I was trained initially, using a non-rebreather was a standard tool for intrauterine resuscitation with a category II fetal pattern, as long as Pitocin was not being utilized. Based on research, this is no longer a current practice. Supplemental oxygen should only be used to treat maternal hypoxia. Research has shown that supplemental oxygen outside of the use for maternal hypoxia is not beneficial to the fetus and may even cause harm (Hamel, Anderson, Rouse, 2014).

When managing laborers, we are under constant pressure by the residents to titrate Pitocin. This may even occur when the patient is making cervical change. If a patient is making cervical change, with a regular contraction pattern, the continued titration of Pitocin is not needed. The RN may need to explain to the resident why their request will not be granted. Some residents can become very task-oriented and want to push the issue. Pitocin titration aims to get the patient to achieve adequate contractions and make cervical change, not to titrate to the point of maternal or fetal distress.

References

Hamel, M., Anderson, B., Rouse, D. (2014). Maternal-fetal specialists at W&I question oxygen use for intrauterine resuscitation. Rhode Island Medical Journal, 97(3), 66. Retrieved from https://search-proquest-com.americansentinel.idm.oclc.org/docview/1506145724?pq-origsite=summon

Phelps, K., Deavers, J., Seehusen, D. A., & Stevermer, J. J. (2018). Let low-risk moms eat during labor? Journal of Family Practice, 67(6), 379–380. Retrieved from https://web-b-ebscohost-com.americansentinel.idm.oclc.org/ehost/pdfviewer/pdfviewer?vid=1&sid=0112174a-eba6-496d-957f-d74f6127d8b5%40pdc-v-sessmgr01