Assessment of an alternative stabilization device for electronic fetal monitoring (EFM) utilizing external ultrasound (US) and tocodynamometer (Toco) in Labor and Delivery patients.

Objective:  Assess whether the an alternative stabilization device for external EFM such as the Pumpkin Patch can provide safety, comfort and tracing data for interpretation that favorably compare to the circumferential belt system currently in use during labor and delivery. 

Design: This study is a prospective, randomized trial comparing the Pumpkin Patch to the traditional circumferential belt.  Setting: Labor and Delivery unit in an academic medical center

Patients/Participants: A total of 30 pregnant women admitted to Labor and Delivery who satisfy all of the following eligibility requirements will be asked to participate: 18 years or older; at term (37-42 weeks gestation); singleton pregnancy; has no known allergy to adhesives.  Aside from those not meeting the above requirements, any woman meeting one or more of the following criteria will be excluded:high risk/critically ill pregnancy; patient declines consent; BMI over 30; elective repeat C/S

Methods: A Nurse Assessment Survey and a Patient Satisfaction Survey will be utilized.  Analysis will include comparing the average number of required nurse monitor adjustments per hour and the nurse experience using the Nurse Assessment Survey; T-test will be utilized.  A Patient Satisfaction Survey will be utilized to assess the patient experience.

Results: Expected results include

• Adjusting the Pumpkin Patch device will be at least equivalent to that of the circumferential belt; it is hoped that data will show less adjustments are needed with the Pumpkin Patch device. Therefore, lower adjustment frequency corresponds with higher device efficacy..
• The Nurse Assessment Survey Likert score medians will be higher for the Pumpkin Patch group.
• The Patient Satisfaction Surveys will show higher scores for the Pumpkin Patch device

Conclusion/Implications for nursing practice: This research will allow us to identify another option for maintaining external electronic fetal monitoring devices for women entering Labor and Delivery. The proposed benefits of this device for the patient include improved stabilization of US and Toco monitors and increased comfort during labor. For the healthcare staff, the device may decrease the time spent adjusting the EFM apparatus as compared to the current standard and also improve the accuracy of fetal heart rate tracing interpretation. This may be especially beneficial during procedures performed while the patient is wearing the US and Toco monitors (e.g. epidural administration, restroom use, etc.).

Keywords:  Pumpkin Patch device, electronic fetal monitoring