Michelle Collins

Nitrous Oxide for the Management of Labor Pain: A Systematic Review

BACKGROUND:We systematically reviewed evidence addressing the effectiveness of nitrous oxide for the management of labor pain, the influence of nitrous oxide on women’s satisfaction with their birth experience and labor pain management, and adverse effects associated with nitrous oxide for labor pain management. METHODS:We searched the MEDLINE, EMBASE, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases for articles published in English. The study population included pregnant women in labor intending a vaginal birth, birth attendees or health care providers who may be exposed to nitrous oxide during labor, and the fetus/neonate. RESULTS:We identified a total of 58 publications, representing 59 distinct study populations: 2 studies were of good quality, 11 fair, and 46 poor. Inhalation of nitrous oxide provided less effective pain relief than epidural analgesia, but the quality of studies was predominately poor. The heterogeneous outcomes used to assess women’s satisfaction with their birth experience and labor pain management made synthesis of studies difficult. Most maternal adverse effects reported in the literature were unpleasant side effects that affect tolerability, such as nausea, vomiting, dizziness, and drowsiness. Apgar scores in newborns whose mothers used nitrous oxide were not significantly different from those of newborns whose mothers used other labor pain management methods or no analgesia. Evidence about occupational harms and exposure was limited. CONCLUSIONS:The literature addressing nitrous oxide for the management of labor pain includes few studies of good or fair quality. Further research is needed across all of the areas examined: effectiveness, satisfaction, and adverse effects.

Nitrous Oxide as Labor Analgesia: Clinical Implications for Nurses

A new interest in self-administered nitrous oxide for labor analgesia has emerged in recent years in the United States. It has been used widely in Europe for decades, with favorable results. The American College of Nurse-Midwives published a position statement in 2010 supporting the practice of self-administered nitrous oxide as an additional analgesia choice for laboring women. Recent literature on this subject has been directed toward midwives, obstetricians and/or anesthesiologists, with little emphasis for labor and delivery nurses. This article presents highlights of nursing care for women using self-administered nitrous oxide during labor and birth.A new interest in self-administered nitrous oxide for labor analgesia has emerged in recent years in the United States. It has been used widely in Europe for decades, with favorable results. The American College of Nurse-Midwives published a position statement in 2010 supporting the practice of self-administered nitrous oxide as an additional analgesia choice for laboring women. Recent literature on this subject has been directed toward midwives, obstetricians and/or anesthesiologists, with little emphasis for labor and delivery nurses. This article presents highlights of nursing care for women using self-administered nitrous oxide during labor and birth.

Establishing a Volunteer Doula Program Within a Nurse‐Midwifery Education Program: A Winning Situation for Both Clients and Students

The use of labor doulas is beneficial for mothers and newborns, but availability and cost can be barriers. The Nashville Volunteer Doula Program was formed to provide labor support to clients of a faculty nurse-midwifery practice. The volunteer doula pool is comprised of both nurse-midwifery students who have trained as doulas and community doulas. Training and coordination of volunteers are managed by nurse-midwifery students with faculty support. Students gain valuable exposure to providing supportive care during labor and birth, which augments their nurse-midwifery education. This novel program operates at a low cost and offers benefits to students as well as women who use the doula service. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health.

Team-Based Learning for Midwifery Education

INTRODUCTION Many US health care and education stakeholder groups, recognizing the need to prepare learners for collaborative practice in complex care environments, have called for innovative approaches in health care education. Team-based learning is an educational method that relies on in-depth student preparation prior to class, individual and team knowledge assessment, and use of small-group learning to apply knowledge to complex scenarios. Although team-based learning has been studied as an approach to health care education, its application to midwifery education is not well described. METHODS A masters-level, nurse-midwifery, didactic antepartum course was revised to a team-based learning format. Student grades, course evaluations, and aggregate American Midwifery Certification Board examination pass rates for 3 student cohorts participating in the team-based course were compared with 3 student cohorts receiving traditional, lecture-based instruction. RESULTS Students had mixed responses to the team-based learning format. Student evaluations improved when faculty added recorded lectures as part of student preclass preparation. Statistical comparisons were limited by variations across cohorts; however, student grades and certification examination pass rates did not change substantially after the course revision. Although initial course revision was time-consuming for faculty, subsequent iterations of the course required less effort. DISCUSSION Team-based learning provides students with more opportunity to interact during on-site classes and may spur application of knowledge into practice. However, it is difficult to assess the effect of the team-based learning approach with current measures. Further research is needed to determine the effects of team-based learning on communication and collaboration skills, as well as long-term performance in clinical practice. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health.

Prevention of Vitamin K Deficiency Bleeding.

The risk that a newborn will develop vitamin K deficiency bleeding is 1700/100,000 (one out of 59) if vitamin K is not administered. When intramuscular vitamin K is administered, the risk of vitamin K deficiency bleeding is reduced to 1/100,000. While women may have misconceptions about vitamin K prophylaxis for their newborns, health care providers should be prepared with factual information. Prophylaxis is needed even for healthy newborns without risk factors for bleeding. Other forms of vitamin K supplementation, including oral administration of Food and Drug Administration-approved vitamin K preparations and maternal supplements during pregnancy or lactation, do not have the same effectiveness as the parenteral form. The formulations of vitamin K approved for use in the United States have not been associated with childhood leukemia or other childhood health problems. Care providers need to give accurate information to families regarding the risks and benefits of vitamin K prophylaxis. An interprofessional approach to education can be effective in increasing acceptance of vitamin K prophylaxis and decreasing the incidence of vitamin K deficiency bleeding. This article uses a case study approach to highlight common misconceptions about vitamin K prophylaxis and discuss a recent interprofessional collaboration to prevent vitamin K deficiency bleeding.

Strategies to Enhance Success Among Dual-Specialty Students in Advanced Practice Nursing Programs.

BACKGROUND In attempts to simultaneously address the 2008 Consensus model and meet the growing need for advanced practice nurses with a robust scope of practice, some schools of nursing offer dual advanced practice nursing (APN) programs. METHOD Built on the successes of multiple dual programs at two universities, this article provides specific practice strategies to enhance academic success among students and faculty in dual-specialty APN programs. RESULTS Faculty- and student-led strategies are outlined, addressing the academic and professional aspects of the dual APN role. With implementation of these strategies, graduation and subsequent dual certification rates in these programs remains extremely high. CONCLUSION Adaptation of these strategies to support student and faculty efforts can potentiate additional opportunities for successful dual APN programs. [J Nurs Educ. 2016;55(8):463-466.

A Model for Enhancing Midwifery Education With a Global Health Certificate

Global health is centered on promoting health equity for all populations. There is a growing need for midwives to receive education in the field of global health in order to be equipped to care for diverse populations within the United States and internationally. Midwifery students benefit from the opportunity to complete global health coursework and a global health practicum, as these experiences help them learn how to reduce local and global health disparities through interdisciplinary collaboration and international partnerships. The purpose of this article is to provide an overview of how a graduate certificate in global health can be used to enhance and enrich midwifery education. The article evaluates the numerous benefits of the global health certificate for midwifery students, and it discusses the logistical challenges of implementation, including potential areas for improvement. By collaborating together, midwifery education programs can expand the breadth of global health courses and practicum experiences available to midwifery students and prepare them to engage in global health projects that improve maternal and neonatal health outcomes in the United States and around the world.

Teaching Labor Support: An Interprofessional Simulation.

Support for women during labor encompasses the continuous presence of a person who provides psychosocial, emotional, and physical support. Providing labor support to women in the intrapartum setting is a core midwifery competency and a clinical skill that midwifery students are expected to master. Instruction on labor support is a common objective in midwifery education intrapartum courses and skills labs, yet there is no standard for teaching this skill to midwifery students. Thus, in order to accomplish this objective, we created an interprofessional simulation on labor support that involves the use of a standardized patient, a written scenario, an interprofessional team of nursing and midwifery students, faculty observations, and a reflective debrief. The goals of the labor support simulation are to allow midwifery students the opportunity to practice intrapartum labor support techniques and interprofessional communication prior to entering the clinical setting. A postsimulation structured debrief allows for student learning and reflection. This article describes the design, planning, and implementation of this unique simulation experience. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health.

A Nurse's Guide to Presenting and Publishing: Dare to Share

By Kathleen T. Heinrich. Sudbury, MA: Jones and Bartlett Publishers, 2008. 472 pages.

A Nurse's Guide to Presenting and Publishing: Dare to Share, Kathleen T. Heinrich. Jones and Bartlett Publishers, Sudbury, MA (2008), 472 pages.

46.95, paperback.Written for every nurse, A Nurse’s Guide to Presenting and Publishing is a resource for baccalaureate, graduate and doctoral students, a companion text for professional development, or a handbook for small groups in practice settings. The small steps shared in this book have helped hundreds of students, staff nurses, advanced practice nurses, and nurse managers to accept the challenge and dare to share their experience with others. Now you can learn to do the same! eLearning Custom Solutions Brand & Partners Enter Keyword, Title, Author or ISBN Technical Support