Remifentanil for Labor Analgesia: An Evidence Based Practice Project
Abstract
Background or Problem/Issue: Neuraxial analgesia is the most common and effective method for pain management during labor due to its minimal maternal and fetal risks (Devabhakthuni,2013). Contraindications to neuraxial analgesia can limit its availability to some parturients (Balki, Kasodekar, Dhumne, Bernsetin, and Carvalho, 2007). Remifentanil has emerged as a safe and effective alternative for pain management during labor in the parturient (Volmanen, Akural,Raudaskoski, and Alahuta, 2002). Previously at Fort Belvoir Community Hospital (FBCH) there was lack of standardization for the administration and nursing care of parturients receiving remifentanil. Clinical Question or Purpose: The purpose of this evidence-based practice (EBP) project was to increase knowledge and develop an evidence-based protocol that standardized administration and nursing care for the parturient receiving remifentanil. Project Design: This project was a pre- and post-implementation performance improvement project. An evidence-based remifentanil protocol was developed that specified patient population, mode of administration, dosage, and nursing care to be implemented on FBCHs labor and delivery unit. An educational intervention (EI) with a vignette was constructed and presented to anesthesia providers (AP), obstetric providers (OB), and labor and delivery nursing staff (NS). The groups were provided the same five-question pre- and post-test that evaluated the effectiveness of the EI. One-month post-implementation the AP were given a modified Evidence-Based Practice Implementation Scale that assessed whether they changed their practice based on the EI. Analysis of Results: The pre-test illustrated a baseline of limited knowledge on remifentanil. The EI proved to be effective as illustrated from the increase in the pre- and post-test scores.
Document Details
- Document Type
- Technical Report
- Publication Date
- Mar 12, 2018
- Accession Number
- AD1131994
Entities
People
- John Iii Tranberg
- Marylou Proano
Organizations
- Uniformed Services University of the Health Sciences