Title: Fall Risk Screen for the Post Epidural/Post Partum Patient
- Define the assessment components of the Fall Risk Screen for the Post-epidural/Postpartum Patients.
- Describe the physiologic significance of assessing for the return of pre-epidural levels for deep tendon reflexes and motor strength prior to ambulation.
- Describe the process for assessment of deep tendon reflexes and the Motor Strength Scale
Design: Descriptive, observational design.
Setting: Low/Moderate risk intrapartum/postpartum patients who received an epidural for pain control during labor.
Patients/Participants: Sample size: 100 low/moderate risk obstetric patients with an epidural
Exclusion Criteria: Delivery by cesarean section
Baseline Muscle Strength Scale of <4
Methods: Obstetrical RNs assessed study patients' deep tendon reflexes (DTRs) and motor strength using the Motor Strength Scale (MSS) prior to receiving epidural anesthesia and again prior to ambulating postpartum. If a subject's DTRs and/or MSS scores did not return to baseline following receipt of epidural anesthesia, the subject was not ambulated and was reassesed prior to next ambulation attempt. If a subject's scores returned to baseline, the subject was assisted with ambulation. The nurses evaluated the subject's success in ambulation using the following criteria: ambulating without lower extremity weakness or buckling of knees. Data were gathered and entered by the RN onto the data sheet assigned to each subject.
Results: Data were collected on 100 subjects. Of this number, 91 (91%) subjects successfully ambulated. Nine (9%) required assistance on ambulation. There were no falls.
Conclusion/Implications for nursing practice: The results supported the assessment of return to baseline levels DTR and MSS for indication of readiness to ambulate. The results of this study support the addition of these assessments into the standard of care for the postpartum patient.
Keywords: postpartum, epidural, motor strength