Date of Award

Winter 2023

Project Type

Clinical Doctorate

College or School

CHHS

Department

Nursing

Degree Name

Other

First Advisor

Patricia Puccilli

Second Advisor

Nancy Mizzoni

Abstract

BACKGROUND: Having a baby can be one of the most challenging and painful experiences a woman has in their lifetime. Being able to choose between a variety of pharmacological and non-pharmacological pain-control methods is important to improve the patient experience and outcomes. This quality improvement project aimed to introduce a virtual reality device into the labor and delivery setting as a non-pharmacological pain control method. The goal was to decrease pain and anxiety levels, decrease the rate of epidural anesthesia use, and decrease the length of time epidural anesthesia medication was running before delivery.

METHODS: The four key components of a quality improvement project were used. An initial educational module was created for nursing staff before the implementation of the device. Additionally, a retrospective chart review was performed to determine epidural rates, duration of running times of epidural anesthesia, and intravenous pain medication rates. Implementation of a virtual reality device was trialed for 8 weeks in the labor and delivery setting. Pain and anxiety measures were taken as well as data on epidural anesthesia use and IV pain medication administration.

RESULTS: Eight participants used the virtual reality device during the implementation period. A slight decrease in pain levels was experienced by the participants, and a more significant decrease in anxiety levels was determined. The retrospective chart reviews showed higher than the national average epidural anesthesia rates for four of the five months. The length of time epidural anesthesia ran before delivery varied from 11.2 hours to 18.3 hours for cesarean section deliveries and 6.8 hours to 9.4 hours for vaginal deliveries. The rate of IV pain medication varied from 4.9% to 9.8%. The rate of epidural anesthesia for the virtual reality participants was 75%, higher than the national average but the average running time of epidural anesthesia was 6.2 hours. The recommendation to continue to use a virtual reality device on the unit by staff was 100%.

CONCLUSIONS: A virtual reality device is an effective non-pharmacological pain control method in the labor and delivery setting. It can decrease pain and anxiety levels for this patient population and decrease epidural anesthesia rates and running time. With further utilization, virtual reality has the potential to decrease labor interventions and/or cesarean section rates. Continuing to use a virtual reality device for this clinical setting is recommended.

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Submitted 11/20/2023

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