Reducing Cesarean Sections with Peanut Ball Use: A Quality Improvement Project

Cesarean sections, although sometimes medically necessary, carry multiple risks and complications. Movement and frequent repositioning throughout labor has been shown to support the natural physiologic process of birth, leading to less medical intervention and increased incidences of vaginal deliveries. The peanut ball is a variation of a birthing ball that assists women with this movement and repositioning. The purpose of this quality improvement project was to see if increasing nursing knowledge on peanut ball benefits, risks, and proper technique would reduce cesarean section rates. It is expected that peanut ball use throughout labor would decrease cesarean sections and increase the probability of vaginal delivery. The Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Model guided this project with a three-step process called PET, practice question, evidence, and translation. Best evidence recommendations were formulated following internal and external evidence review and quality appraisal. Before implementation, peanut balls were stocked, and 91% of the staff nurses attended an educational intervention outlining appropriate peanut ball use. Chart audits occurred from a newly added section within the labor flowsheet after three months, reflecting peanut ball use for 251 patients (16%). The hospital\u27s cesarean section rates for the three months before and after implementation were compared, showing no statistically significant difference. An increase in nursing knowledge and the availability of peanut balls successfully led to the integration of the peanut balls into daily practice in a labor and delivery unit. Peanut balls are labor tools that nurses can use to help patients maintain adequate pelvic positioning to promote vaginal delivery despite the immobility brought on by epidural anesthesia