Nursing Discussion 2

In order to evaluate an evidence-based practice project, it is important to be able to determine the effectiveness of your change. Discuss one way you will be able to evaluate whether your project made a difference in practice. Answer with APA references.ANSWER HAS TO BE RELATED TO MY EBP PROJECT. MY EBP PROJECT TOPIC IS ATTACHED.
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EBP Project Abstract
Appraised by: Sevil Aliyeva, KellyDeraas, and Morgan Johnson
Clinical Question:
Do pregnant women who have elective labor inductions at term (39-41 weeks) have an increased
risk of unplanned cesarean sections compared to those who go into spontaneous labor?
Articles:
Ehrenthal,D.B., Jiang,X.,&Strobino, D.M.(2010). Labor induction and the risk of a cesarean
delivery among nulliparous women at term. Obstetrics and gynecology, 116, (1), 35-42.
Jonsson, M., Cnattingius, S., & Wikstrom, A. (2013). Elective induction of labor and the risk of
cesarean section in low-risk parous women: a cohort study. Acta Obstetricia Et
Gynecologica Scandinavica, 92(2), 198-203.
Tam, T., Conte, M., Schuler, H., Malang, S., & Roque, M. (2013). Delivery outcomes in women
undergoing elective labor induction at term. Archives of Gynecology and Obstetrics, 287,
(3), 407-11.
Synthesis of Evidence:
All three studies were a level IV retrospective cohort studies. Ehrenthal, Jiang, and Strobino,
(2010) used a total of 7804 women and labor induction was used in 43.6% of women. Elective
labor induction was the method/intervention used in 39.9% of the women. The study was
conducted over two years and seven months. Labor induction had increased the chances of
unplanned cesarean sections by 20%. Jonsson, Cnattingius, and Wikstrom, (2013) conducted a
study for parous women with no comorbidities or pregnancy complications. A total of 7973
women were used, and 343 women had elective labor induction. Out of the women who were
electively induced, 52% failed to progress and had unplanned cesarean sections. Another
complication was non-reassuring fetal heart rate which happened to 26% of electively induced
women and lead to emergent cesarean sections. Elective inductions more than doubled the risk of
unplanned cesarean sections. Tam, Conte, Schuler, Malang, and Rogue, (2013) conducted a
study for low-risk women. A total of 848 pregnant women were included, with 694 of these
women having a successful vaginal delivery and 154 having a caesarean delivery. Women who
had a favorable cervical exam and multiparity had a greater chance of having a successful
vaginal delivery. Studies showed a correlation between elective labor inductions and unplanned
cesarean sections.
Bottom Line: (findings)
The evidence suggests that elective labor inductions increased the risk of unplanned cesarean
sections.
Implications for Nursing Practice:
Nurses should be aware of the risks of elective labor inductions. The nurse educators and
practitioners need to teach the staff about these risks and implement the teaching into the
prenatal visits. Nurses and practitioners need to take the responsibility to inform the patient about
the increased risks of cesarean sections due to elective inductions. Nurses need to be the
advocate for the patient when the patient is not informed about the risks that go along with labor
inductions. The nurses and practitioners have a duty to perform thorough assessments of the
cervical condition and inform the patient if the cervix is not in favorable condition before
discussing the option of labor induction. Nurses and practitioners should be aware of risk factors
and co morbidities that can increase the risk of unsuccessful elective induction before they
consider this option.

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