Date of Award

2017

Degree Name

PhD Nursing

Dissertation Committee

Cynthia D. Connelly, PhD, RN, FAAN, Chairperson Ruth Bush, PhD, MPH, MA Sophie Hutchins, DNP, MS

Keywords

EFM, electronic fetal monitor, fetal monitoring, labor monitoring, obstetrics

Abstract

Purpose: The most common obstetric procedure in the United States is use of an electronic fetal monitor (EFM), which is employed to predict and eliminate hypoxic injury during birth. However, since inception of the EFM in the 1960s, incidence of hypoxic injury has remained nearly the same. Riddled with conflicting and confusing data, the EFM often creates an environment of defensive medicine in order to ward off potential legal implications of misinterpretation of the EFM. The cesarean birth is currently accepted as the most definitive method of birth to avoid potential hypoxic injury, and although it is often used in the setting of defensive medicine there is very little scientific data to support this view. Consequently, there has been an exponential increase in unplanned cesarean births leading to a national epidemic. The purpose of this study is to test the feasibility and acceptability of adhesives to be used on a new EFM with significant functional improvement.

Methodology: The i-MOM study will assess the feasibility and acceptability of utilizing adhesives for EFMs in lieu of belts in an antenatal non-stress test clinic for fetal observation. Survey data will be collected from participant mothers and providers regarding the usability and likeability of the proposed adhesive EFMs versus standard belted EFMs in 21 patients.

Results: Statistical significance was found when assessing four separate adhesives, showing both participant mothers and providers preferred two particular adhesives. There was statistical significance in the performance of adhesive versus belted EFMs when measuring application, adjustment, and identification of fetal heart rate. However, there was no significance found when assessing the number of times adjustments were needed to continually monitor fetal heart rate.

Conclusions: The i-MOM study assessed the feasibility of four adhesives utilized on current EFMs and went on in a separate follow-up study to show a new enhanced adhesive EFM performed as well as the current belted option. Data provided from this study will help to inform the parent study of preferences reported by mothers and practitioners regarding different adhesives. Additionally, it will inform researchers about further improvements to be made in order to provide a wireless and conformal electronic fetal heart monitor in the future.

Document Type

Dissertation: USD Users Only

Department

Nursing

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