A Nurse-Directed Model for Nitrous Oxide Use During Labor.

Area of Science:

• Obstetrics and Gynecology
• Pain Management
• Quality Improvement

Background:

• Nitrous oxide (N2O) is a globally recognized, safe, effective, and economical method for labor pain relief.
• Despite its benefits, N2O use is notably underutilized in the United States healthcare system.
• Rural hospitals with limited perinatal services face challenges in providing adequate pain management due to a lack of in-house anesthesia coverage.

Purpose of the Study:

• To implement and evaluate a nurse-driven, self-administered nitrous oxide program for labor pain management in a rural hospital setting.
• To address the limited pain relief options available to laboring women in facilities without 24/7 anesthesia support.

Main Methods:

• A quality improvement project was initiated, involving the development and implementation of a demand-flow nitrous oxide system.
• Registered nurses from Women's Services led the project, utilizing an interdisciplinary team and expert consultations.
• The project included cost analysis, patient satisfaction surveys, and outcome monitoring.

Main Results:

• Since implementation, approximately 50% of laboring patients have utilized nitrous oxide.
• The majority of surveyed patients reported N2O as helpful for managing mild-to-moderate labor pain.
• No adverse effects were observed in mothers or newborns following N2O administration.

Conclusions:

• Nurse-initiated and managed nitrous oxide is a safe, cost-effective approach to labor pain relief.
• This program offers a viable solution for hospitals, especially those without continuous in-house anesthesia services.
• The project highlights the potential for expanding N2O accessibility in underserved U.S. hospital settings.