Date on Paper

8-2023

Document Type

Doctoral Paper

Degree Name

D.N.P.

Department

Nursing

Committee Chair

Robertson, Sara

Committee Member

Corniel, Brittney

Author's Keywords

abdominal binder; cesarean section; nonpharmacologic

Abstract

A cesarean section is a major abdominal surgery with a unique recovery profile. The patient must recover from surgery while simultaneously coping with a major life event: the birth of a new baby. The utilization of pain management techniques with as few side effects as possible is paramount to ensure optimal maternal and newborn outcomes (Karlström et. al., 2007; Eisenach et. al., 2008). On an inpatient mother/baby unit at a high-risk urban hospital in Louisville, Kentucky approximately 66 babies are born via cesarean section every month (Mattingly, 2021). However, in the fall of 2021, it was discovered that there was no protocol in place to ensure that each of these post-cesarean patients were offered a minimally invasive, nonpharmacologic pain management device: an abdominal binder (Abd-ElGawad et al., 2021 & DiMascio et al., 2021). The purpose of this quality improvement project was to evaluate the efficacy of an educational intervention aimed at standardizing the procedure and increasing the rate at which nursing staff offered post-cesarean patients abdominal binders. Participants included post-cesarean patients that met inclusion criteria and delivered during late 2022 and early 2023. Data was collected through a retrospective chart review and included demographics, delivery information, and abdominal binder offering and use. The majority of the population was composed of Black, Indigenous, and people of color (BIPOC), and most underwent a primary c-section. The largest percentage of each population also had body mass indexes (BMIs) of 40 or higher. Following the educational intervention, abdominal binders were offered at a significantly higher rate both within 48 hours post-cesarean and before discharge. Additionally, abdominal binder use significantly increased. A chi square analysis also revealed no significant association between abdominal binder offering and race/ethnicity or BMI, which is encouraging given the history of racial and weight-related bias in healthcare.

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