Models and Barriers L&D
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Models and Barriers in Labor and Delivery
Ashley A. Magana College of Nursing and Health Innovation, University of Texas at Arlington
NURS 5367: Evidence-Based Practice
Dr. Judy LeFlore Ph.D., RN, NNP-BC, CPNP-AC&PC, ANEF, FAAN
January 11, 2024
2
Models and Barriers in Labor and Delivery
Labor and delivery is a critical care unit in most if not all hospitals. Nurses working in this environment go through extensive training despite having finished all the training and education required to become a nurse. In the training that is given at the hospital once you become a labor and delivery nurse, there is a considerable amount of information that has to do with evidence-based practice. One of the evidence-based practices that stands out is avoiding routine interventions and restrictions. Many of the aspects of this evidence-based practice are seen often in Labor and Delivery. In this paper barriers and ways to overcome those barriers will be discussed, as well as an evidence-based practice model that will work in Labor and Delivery.
Examples
In Labor and Delivery, a patient walked in to be admitted because she believed she was in labor. The patient was indeed in labor, but she was not significantly dilated at the time she arrived at the unit. This patient was prepared with a birth plan for herself and her child. The birth
plan entailed almost everything that comes with routine interventions and restrictions. The patient was adamant that there be to intravenous fluids, no medication, no fetal monitoring, and no augmentation of labor. The patient essentially wanted to delivery her child in the hospital in case any emergency was to arise. Unfortunately, the physician was not on the same page as the patient. After several conversations between the physician and the patient, the patient gave in. An IV was started as well as medication to augment labor. The barrier in this situation would be lack of support and time. Physicians are busy and have many laboring women at one moment, in turn, decisions are made that make their profession a little easier, but less of what the patient needs or wants. Another example is that all laboring patients are prohibited from eating or drinking anything during the laboring process. Patients are only allowed to have ice chips. The
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