Nurses Have The Opportunity For Play A Pivotal Role Essay

Nurses Have The Opportunity For Play A Pivotal Role Essay

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According to Steen and Marchant (2007), 60-70% of women will require sutures after vaginal delivery. A common morbidity of lacerations in the perineum is acute pain (Steen et al., 2007). Indeed, many women who have had birth related lacerations have decreased mobility, difficulty sitting comfortably, or fear of defecation due to pain (Steen et al. 2007). Furthermore, this pain may impede a mother from breastfeeding, focusing on newborn care and can lead to increasing irritability (Steen et al., 2007).
Nurses have the opportunity to play a pivotal role in addressing perineal pain by assessing lacerations, assessing pain levels and providing pharmacological and non-pharmacological pain relief methods. The most common non-pharmacological interventions are localized cooling (ice packs, gel pads) and heat based interventions (dry heat, Sitz baths) (Steen et al., 2007). Despite the prevalence of these methods there is little evidence to support their effectiveness and safety in a practice environment (Steen et al., 2007). Rather, many of these interventions are based on ritual, rule of thumb and past clinical experience (Steen et al., 2007). In an attempt to investigate this knowledge to practice gap I will focus on one specific intervention, cryotherapy (ice therapy). First I will describe a clinical example of a woman who used cryotherapy for perineal pain. Second, I will present current evidence on this intervention. Last, I will explore how this evidence would have informed my actions in my clinical example as well as, some of the challenges to implementing this evidence in a practice setting.
Part One: Presentation of Patient
My patient was a healthy 28 year-old primiparous woman who had vaginally delivered a health ...

... middle of paper ...

...vidence based non-pharmacological pain relief methods such as localized cooling methods.
In conclusion, perineal pain is a common experience among women who have had a vaginal birth (Steen et al., 2007). Research by Steen and Marchant (2007) affirmed that cryotherapy is a safe and effective nursing intervention for treating perineal pain in women. When applying this evidence to practice there are a number of challenges of implementation, such as, the cost of the treatment, practice envrionment and lack of standardization. Moreover, the application of this evidence to a clinical setting should not supplant the clinical judgment of the nurse or the preference of the patient. Finally, before developing best practice guidelines in perineal pain care more exhaustive research needs to be conducted that addresses application time and use for women who have had epidurals.

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