Grand Canyon Nursing Professional Capstone and Practicum Reflective Journal Students are required to maintain weekly reflective narratives throughout the c

Grand Canyon Nursing Professional Capstone and Practicum Reflective Journal Students are required to maintain weekly reflective narratives throughout the course to combine into one course-long reflective journal that integrates leadership and inquiry into current practice as it applies to the Professional Capstone and Practicum course.

In your journal, you will reflect on the personal knowledge and skills gained throughout this course. The journal should address a variable combination of the following, depending on your specific practice immersion clinical experiences:

New practice approaches
Intraprofessional collaboration
Health care delivery and clinical systems
Ethical considerations in health care
Population health concerns
The role of technology in improving health care outcomes
Health policy
Leadership and economic models
Health disparities

Students will outline what they have discovered about their professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and finally, how the student met the competencies aligned to this course.

While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines,

MY EBP PROJECT IS ATTACHED FOR REFERENCE, ALSO FIND THE ATTACHED RUBRIC. HEALTH
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Research Proposal
Name
Instructor
Institutional Affiliation
Date
HEALTH
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DETERMINING WHETHER ELECTIVE LABOUR INDUCTION IN PREGNANT WOMEN
INCREASES THE TENDENCY OF UNPLANNED CESAREAN SECTIONS
Background
If there is anything that makes women more special than men, then it must be their ability to
carry a fetus in their womb for approximately nine months and then eventually give birth. That is
the reason we all respect our mothers. We assume that they gave us life, regardless of the fact
that our fathers also played a prominent role in the process. However, women have had to carry
the burden that comes with the process of giving birth. Many women have died in the process,
some have even had lifelong complications such as secondary subfertility, and others have
undergone puerperal psychosis. Am mentioning all these things so that we appreciate the role of
women and the risks involved. This research proposal is mainly about the relationship between
elective labor induction and cesarean section in expectant women. Does inducing labor in a
pregnant woman at term increase the probability of having a cesarean section done on her? This
is an issue which has been highly debated.
When labor is induced, it merely means that the process is not physiological and that both the
mother and the fetus are not yet ready. Inducing labor forces the fetus to come out unprepared
and might experience some complications, either short term or long term. Physiologically, during
the third trimester of pregnancy, the fetus’s lungs mature, and the fetus rotates in the womb into
an appropriate position and presentation. The fetus might not have time to undergo all these slow
natural processes that occur before birth when labor is induced. The topic of cesarean section and
labor induction has been controversial with some previous studies showing contradicting results.
Some studies show that labor induction reduces cesarean section rates whereas others show no
HEALTH
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relationship at all. My hypothesis suggests that labor induction increases the risk of a cesarean
delivery method.
Problem Statement
The rate at which cesarean sections are being done in our hospitals and most countries has been
on the rise. The increase in cesarean sections also coincides with an increase in labor induction
(Danilack, V. A., et al. 2016). Induction is the leading cause of the rise in cesarean sections, then
it interventions should be made towards that regard. Meaning reduction of labor induction will
consequently reduce cesarean section rates. The rationale of this study is to follow up the events
that happen after labor induction focusing more keenly on cesarean sections done after that. This
will enable us to weigh the risks and benefits associated with labor induction. It will also us to
see the gaps both in the personnel and patient education on labor induction and cesarean section.
Purpose of the Change Proposal
Women who have undergone cesarean section during their first delivery have a more than eighty
percent probability of having cesarean sections in their subsequent pregnancies. This means that
avoiding unplanned cesarean sections, in the first pregnancy, will significantly reduce the overall
cases of cesarean sections. This study aims to prove that labor induction is a predisposing factor
to cesarean sections in pregnant women. After that, interventions will be done towards the
methods in which labor is being induced if it is unavoidable. Training of nurses will also be done
for proper assessment of pregnant women, for example, techniques for cervical examination and
interpretation of partographs. Cesarean section has a lot of disadvantages which are avoidable.
The shortcoming of the cesarean section includes post-partum hemorrhage, delayed recovery
after giving birth, septic wounds and peritonitis amongst many others.
HEALTH
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PICOT
Population/problem
The study population for this research proposal is pregnant women who have had a cesarean
section. We will then follow up if there were previous attempts to induce them into labor. The
study problem is whether labor induction increases the risk of having a cesarean section done.
Indicator/Intervention
Nurses are enlightened on ways of conducting cervical examination properly on expectant
women. The knowledge will help to prevent recommendation of labor induction for patients with
no significant reason.
Comparison / Control
Our control study will be the number of women who underwent cesarean section without being
induced into labor. We will compare this number with that of women who underwent cesarean
section after being induced into labor.
Outcomes
The expectation is that the number of unplanned cesarean sections after labor induction goes
down after the interventions have been done. Therefore the incidence of cesarean section is
expected to go down in the local health center.
Time Frame
The estimated period of study is about six months.
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Question
Does elective labor induction at term increase the incidence of an unplanned cesarean section in
pregnant women as compared to spontaneous vertex delivery?
Literature Search Strategy Employed
My literature search involved mainly primary sources such as journals and articles are written on
labor induction and cesarean section. It also included medical textbooks especially those of
obstetrics and gynecology focusing even on reproductive physiology. Getting these articles also
involved searching online on sites such as google scholar. Most articles and journals also were
about previous topics that had been done. A significant majority range between the years 2013
and 2017. It is important to note that all the literature were written in the English language.
Evaluation of Literature
It would be essential to appreciate the previous works that have been done by researchers on the
topic of labor induction and cesarean sections (Kawakita, T., & Bowers, K. 2018). It is a matter
of concern that the number of cesarean sections is on the rise, both in developed and developing
countries, according to previous research. The risks of labor induction have also been evaluated
to some extent. Some researchers argue that labor induction actually reduces the rate of cesarean
sections. However, they lacked evidence and facts to support this hypothesis. From previous
research, I was able to conclude that elective labor induction poses the great risk both to the
infant and to the pregnant woman. Neonatal complications such as neonatal sepsis have been
proven in pregnancies where artificial rupture of membranes was done. This was the case even
when sterile techniques were used. My current proposal is that labor induction increase cesarean
section rates. Previous research has not looked into this matter deep enough.
HEALTH
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Applicable Change/Nursing Theory Utilized
Since induced labor is not a physiological process, it changes a previously normal pregnancy into
a high-risk category. This predisposes the mother to complications such as an insufficient power
to push the baby out or shoulder dystocia. This eventually leads to emergency cesarean sections.
Implementation Plan/Outcome
Implementation involves, proper training of nurses and midwives on late pregnancy and stages of
labor, proper cervical examination and indications and risks of labor induction. Patients will also
be appropriately educated during antenatal clinics towards this regard. The expected outcome is
that the labor will only be induced when necessary and after proper clinical evaluation.
Potential Barriers
Few challenges are expected in this mission. Lack of sufficient trained personnel is a big
problem in most health facilities. Most pregnant women are also ignorant and do not attend all
their antenatal clinics. Inaccurate from the records might also be very misleading giving out the
wrong impression. However, all these challenges can be avoided by taking data from the correct
sample population. Recruitment of more trained nurses will also be helpful. For this research to
be successful, teamwork and cooperation are required from both the patients and the hospital
staff. Reducing cesarean section rate is our primary aim. This will reduce maternal and neonatal
complications. A healthy reproductive life is satisfying.
HEALTH
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References
Danilack, V. A., Triche, E. W., Dore, D. D., Muri, J. H., Phipps, M. G., &Savitz, D. A. (2016).
Comparing expectant management and spontaneous labor approaches in studying the
effect of labor induction on cesarean delivery. Annals of epidemiology, 26(6), 405-411.
Kawakita, T., & Bowers, K. (2018). Maternal and Neonatal Outcomes of Induction of Labor
Compared with Planned Cesarean Delivery in Women with Preeclampsia at 34 Weeks’
Gestation or Longer. American journal of Perinatology, 35(01), 095-102.
Packard, R. E., &Mackeen, A. D. (2015, October). Labor induction in the patient with preterm
premature rupture of membranes. In Seminars in perinatology (Vol. 39, No. 6, pp. 495500). Elsevier.
Walker, K. F., Bugg, G. J., Macpherson, M., McCormick, C., Grace, N., Wildsmith, C., …&
Thornton, J. G. (2016). Randomized trial of labor induction in women 35 years of age or
older. New England Journal of Medicine, 374(9), 813-822.
2
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