Effectiveness of Peanut Birthing Ball in Laboring Mothers with Epidural

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Use of a Peanut Birthing Ball
During Labor
by
Suzette Arrindell, MSN, RNC-OB
PICO(T) QUESTION
In laboring women, how does the use of a peanut ball, compared with not
using a peanut ball, effect the length of first stage labor and the incidence of
cesarean delivery?
PICO
Patient population:
 
Laboring mothers, specifically with an epidural for pain
      
management
Intervention: 
  
The use of a peanut birthing ball
Comparator:
   
Laboring mothers who do not utilize peanut birthing 
 
      
ball
Outcome: 
   
Shorter duration of labor and decrease in primary 
 
      
cesarean sections
GAP analysis
First stage of labor encompasses the onset of active labor to complete
cervical dilation
Longer duration of labor is associated with increase risk of cesarean section
Repeat cesarean section deliveries account for highest number of cesarean
births
Epidural anesthesia results in limited mobility, which contributes to longer
duration of labor
Evidence for intervention
Peanut balls open the maternal pelvis, aiding in rotation and descent of the
fetus (Roth, Dent, Parfit, Hering, & Bay, 2016).
Women receiving epidural anesthesia are frequently in a modified-supine
position, making the use of a peanut ball beneficial (Payton, 2015).
Use of a peanut ball has been shown to decrease the length of both first and
second stage labor and decrease the incidence of cesarean section delivery
(Tussey, Botsios, Gerkin, Kelly, Gamez, & Mensik, 2015).
SWOT analysis 
(Reavy, 2016)
Projected budget
 
Project leader
The presenter of this presentation is the most qualified to lead this project
based on the following set of skills and experience:
14 years of experience as a Labor and Delivery nurse
Over one year spent providing the research on the need for the projected project
Experience with previous successful change projects lead by the presenter
Willingness to facilitate the project from beginning to the culmination
Positions needed 
(
Roles in change management
, 2017)
Project leader
Develop plans for project
Go-to person during the length of project
Senior manager
Authorize funding for project
Unit manager
Guides and support project team
Project team
Labor and delivery staff nurses to implement project
Provide feedback on collection tool
Project support team
Experienced staff nurses
Provide additional guidance and support throughout project process
References
Payton, C. (2015). Use of a peanut ball to decrease first and second stages of labor. 
Graduate thesis,
dissertations, and capstones, paper
 14. Retrieved
 
from
http://scholarworks.bellarmine.edu/cgi/viewcontent.cgi?article=1013&context=tdc
Reavy, K. (2016). 
Inquiry and leadership: A resource for the DNP project
. Philadelphia, PA: F.A. Davis Company 
Roles in change management
. (2017). Retrieved from https://www.prosci.com/change-management/thought-
leadership-library/roles-in-change-management
Roth, C., Dent, S., Parfit, S., Hering, S., & Bay, R. (2016). Use of the peanut ball during labor. 
American journal
of maternal child nursing
, 
41
(3), 140–146. doi: 10.1097/NMC.0000000000000232
Tussey, C., Botsios, E., Gerkin, R., Kelly, L., Gamez, J., & Mensik, J. (2015). Reducing length of labor and
cesarean surgery rate using a peanut ball for women laboring with an epidural. 
Journal for perinatal education,
24
(1), 16-24. doi: 10.1891/1058-1243.24.1.16
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The use of a peanut birthing ball during labor for mothers with epidurals aims to reduce the duration of the first stage of labor and decrease the incidence of primary cesarean sections. Evidence suggests that peanut balls help open the maternal pelvis, aiding in fetal rotation and descent. This intervention can lead to shorter labor times and lower rates of cesarean deliveries, particularly beneficial for women with limited mobility due to epidural anesthesia. Implementing peanut balls presents opportunities for improving patient outcomes and satisfaction, although challenges such as patient resistance and staff training may arise.


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  1. Use of a Peanut Birthing Ball During Labor by Suzette Arrindell, MSN, RNC-OB

  2. PICO(T) QUESTION In laboring women, how does the use of a peanut ball, compared with not using a peanut ball, effect the length of first stage labor and the incidence of cesarean delivery?

  3. PICO Patient population: Laboring mothers, specifically with an epidural for pain management Intervention: The use of a peanut birthing ball Comparator: Laboring mothers who do not utilize peanut birthing ball Outcome: Shorter duration of labor and decrease in primary cesarean sections

  4. GAP analysis First stage of labor encompasses the onset of active labor to complete cervical dilation Longer duration of labor is associated with increase risk of cesarean section Repeat cesarean section deliveries account for highest number of cesarean births Epidural anesthesia results in limited mobility, which contributes to longer duration of labor

  5. Evidence for intervention Peanut balls open the maternal pelvis, aiding in rotation and descent of the fetus (Roth, Dent, Parfit, Hering, & Bay, 2016). Women receiving epidural anesthesia are frequently in a modified-supine position, making the use of a peanut ball beneficial (Payton, 2015). Use of a peanut ball has been shown to decrease the length of both first and second stage labor and decrease the incidence of cesarean section delivery (Tussey, Botsios, Gerkin, Kelly, Gamez, & Mensik, 2015).

  6. SWOT analysis (Reavy, 2016) Strengths Weaknesses Patient resistant to awkward position Repositioning every 20-60 minutes unappealing Environment that encourages change The exceptionally low cost of the equipment needed Non-invasive and non- pharmaceutical Opportunities Shorter laboring hours Lower cesarean section rates Opportunity to increase patient satisfaction Threats More experienced nurses resistant to change Physician buy-in

  7. Projected budget Budget for materials Four peanut birthing balls at $40.00 each $160.00 Materials for posters and collection tool $100.00 Budget for staff time One hour needed for presentation and training for 35 nurses $1,400.00 (based on an average hourly salary of $40.00/hour Total projected cost $1,660.00

  8. Project leader The presenter of this presentation is the most qualified to lead this project based on the following set of skills and experience: 14 years of experience as a Labor and Delivery nurse Over one year spent providing the research on the need for the projected project Experience with previous successful change projects lead by the presenter Willingness to facilitate the project from beginning to the culmination

  9. Positions needed (Roles in change management, 2017) Project leader Develop plans for project Go-to person during the length of project Senior manager Authorize funding for project Unit manager Guides and support project team Project team Labor and delivery staff nurses to implement project Provide feedback on collection tool Project support team Experienced staff nurses Provide additional guidance and support throughout project process

  10. References Payton, C. (2015). Use of a peanut ball to decrease first and second stages of labor. Graduate thesis, dissertations, and capstones, paper 14. Retrieved from http://scholarworks.bellarmine.edu/cgi/viewcontent.cgi?article=1013&context=tdc Reavy, K. (2016). Inquiry and leadership: A resource for the DNP project. Philadelphia, PA: F.A. Davis Company Roles in change management. (2017). Retrieved from https://www.prosci.com/change-management/thought- leadership-library/roles-in-change-management Roth, C., Dent, S., Parfit, S., Hering, S., & Bay, R. (2016). Use of the peanut ball during labor. American journal of maternal child nursing, 41(3), 140 146. doi: 10.1097/NMC.0000000000000232 Tussey, C., Botsios, E., Gerkin, R., Kelly, L., Gamez, J., & Mensik, J. (2015). Reducing length of labor and cesarean surgery rate using a peanut ball for women laboring with an epidural. Journal for perinatal education, 24(1), 16-24. doi: 10.1891/1058-1243.24.1.16

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