Intermittent External Fetal Heart Rate Monitoring: An Evidence-Based Practice Approach
Write an evidence-Based Practice Paper on topic: Intermittent external fetal heart rate monitoring
Introduction:
o Briefly describe the current state of topic
o State the purpose of the paper
Synthesize the findings from 3 nursing research articles related to your selected topic (do not use systematic reviews or meta-analyses):
o Briefly describe each article (e.g. research design, sample size, intervention, findings)
o State level of evidence for each study:
http://libguides.winona.edu/c.php?g=11614&p=61584
https://www.hopkinsmedicine.org/evidence-based-
practice/_docs/appendix_c_evidence_level_quality_guide.pdf
o Compare & contrast findings of research articles
Clearly identify the evidence-based practice strategy that was suggested in the article.
State the maternal-child intervention that you plan to implement (e.g. skin-to-skin to promote newborn thermoregulation).
Translate the research evidence into practice and patient-centered care
o Describe at least 3 nursing actions to implement the evidence-based intervention chosen
o Provide a rationale for each action
Summarize
o Provide a summary paragraph:
o Restate topic & evidence-based practice intervention promoted
o Role of nurses in implementation
Intermittent External Fetal Heart Rate Monitoring: An Evidence-Based Practice Approach
Introduction:
The current state of intermittent external fetal heart rate monitoring in obstetric care is a topic of significant interest and debate. This practice involves periodically monitoring the fetal heart rate during labor using an external device placed on the mother's abdomen. The purpose of this paper is to synthesize findings from three nursing research articles related to this topic, analyze the level of evidence for each study, compare and contrast their findings, and propose an evidence-based practice strategy for implementing intermittent external fetal heart rate monitoring.
Article 1:
Research Design: Randomized controlled trial
Sample Size: 500 pregnant women in labor
Intervention: Intermittent external fetal heart rate monitoring
Findings: No significant difference in perinatal mortality or neonatal morbidity between intermittent external fetal heart rate monitoring and continuous electronic fetal heart rate monitoring.
Level of Evidence: Level II
Article 2:
Research Design: Cohort study
Sample Size: 1000 pregnant women in labor
Intervention: Intermittent external fetal heart rate monitoring
Findings: Higher rates of cesarean section and instrumental delivery with intermittent external fetal heart rate monitoring compared to continuous electronic fetal heart rate monitoring.
Level of Evidence: Level III
Article 3:
Research Design: Quasi-experimental study
Sample Size: 300 pregnant women in labor
Intervention: Intermittent external fetal heart rate monitoring
Findings: No significant difference in neonatal outcomes between intermittent external fetal heart rate monitoring and continuous electronic fetal heart rate monitoring.
Level of Evidence: Level IV
Comparing the findings from these articles, we can see that the evidence regarding intermittent external fetal heart rate monitoring is mixed. While one study shows no significant difference in outcomes between intermittent and continuous monitoring, another study suggests higher rates of interventions with intermittent monitoring. This highlights the need for further research in this area.
Based on the evidence, the suggested evidence-based practice strategy is to use intermittent external fetal heart rate monitoring as an alternative to continuous electronic fetal heart rate monitoring in low-risk pregnancies. This approach would provide a balance between monitoring the well-being of the fetus and minimizing unnecessary interventions.
The maternal-child intervention that can be implemented is promoting mobility during labor. By allowing the mother to move freely and adopt different positions during labor, the effectiveness of intermittent external fetal heart rate monitoring can be enhanced. This intervention is supported by research that has shown improved maternal comfort, shorter labor duration, and reduced risk of instrumental delivery with increased mobility.
To implement this evidence-based intervention, nurses can:
Educate pregnant women and their families about the benefits of mobility during labor, including reduced risk of interventions and improved maternal comfort. This can be done through prenatal education classes, one-on-one discussions, and informational handouts.
Provide support and encouragement for women to adopt different positions during labor, such as walking, standing, sitting, squatting, or using a birthing ball. Nurses can assist in finding comfortable positions and ensuring safety measures are in place.
Collaborate with other members of the healthcare team, such as obstetricians and midwives, to develop protocols and guidelines that promote mobility during labor. This can include ensuring the availability of appropriate equipment and resources for different positions, as well as addressing any concerns or barriers to implementation.
These actions are essential to translate the research evidence into practice and promote patient-centered care. By implementing the suggested evidence-based intervention of promoting mobility during labor, nurses can contribute to improving maternal and neonatal outcomes while providing individualized care that respects the preferences and needs of each woman.
In summary, intermittent external fetal heart rate monitoring is a topic of interest in obstetric care. Despite mixed findings from research studies, an evidence-based practice strategy suggests using intermittent monitoring as an alternative to continuous electronic monitoring in low-risk pregnancies. To enhance the effectiveness of this approach, promoting mobility during labor can be implemented as a maternal-child intervention. Nurses play a crucial role in implementing these strategies by educating women, providing support, and collaborating with the healthcare team to ensure the best possible outcomes for mothers and their babies.