The PICO question to address this issue has been presented as: ‘among pregnant women (P), can low-impact structured exercises (I) versus sedentary lifestyles (C) reduce the incidence and intensity of back pain (O)Exercise to Reduce Pregnancy Back Pain?
Restate your PICOT question and its significance to nursing practice.
Summarize the findings from the articles you selected for your literature review. Describe at least one nursing practice that is supported by the evidence in the articles. Justify your response with specific references to at least 2 of the articles.
Explain how the evidence-based practice that you identified contributes to better outcomes. In addition, identify potential negative outcomes that could result from failing to use the evidence-based practice.
Outline the strategy for disseminating the evidence-based practice that you identified throughout your practice setting. Explain how you would communicate the importance of the practice to your colleagues. Describe how you would move from disseminating the information to implementing the evidence-based practice within your organization. How would you address concerns and opposition to the change in practice?
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Restate your PICOT question and its significance to nursing practice
The PICO question has been identified as: “among pregnant women (P), can low-impact structured exercises (I) versus sedentary lifestyles (C) reduce the incidence and intensity of back pain (O)?” The question is targeted at pregnant women as the population of interest since it has been determined that they routinely suffer from back pain that could become debilitating and detrimental. The intention is to address this concern. Given the physical limitations that pregnancy imposes as well as evidence drawn from literature review, it has been determined that low-impact exercise would act as an ideal solution to the problem of perennial and persistent back pain. That is because it allows the pregnant women to work out the back muscles to make them stronger and suppler with minimal negative effect on the pregnancy. The control has been presented as sedentary lifestyle since pregnant women who do not engage in physical activity are anticipated to have weaker back muscles that are easily strained by the pregnancy to cause back pain. As such, the targeted outcome it to reduce the incidence and intensity of back pain among pregnant women Exercise to Reduce Pregnancy Back Pain.
The significance of the problem is that it presents opportunities for sciatica, a condition that presents as lower back pain radiating into the thighs and buttocks that is accompanied by numbness from the nerves being presses by bulging and herniated disk in the lower back (Laughlin & Cristaudo, 2016). Given this concern, there is a need to develop a strategy to prevent the incidence and manage the condition.
There is a general consensus that lower back pain is an issue of concern among pregnant women. That is because the pain is a nuisance and distraction that diminishes the pregnancy event and could also persist beyond the event. Although the mother and baby is not placed in any immediate danger, it causes concerns that would require medical consultations since there are occasions when the pain could cause complications that include premature birth. The concern is further highlighted by the fact that 66% of pregnant women report the problem, though at different intensities (Laughlin & Cristaudo, 2016). The implication is that pregnant women should be subjected to medical strategies to facilitate the prevention and management of back pain.
Teyhen (2014) acknowledges that lower back pain is a source of concern to the medical fraternity, but proposes that physical therapy would address the concern. Applying a systematic review approach reliant on 22 past publications, the articles determined that pregnant women should be subjected to supervised structured exercises to relieve lower back pain with the best results obtained from personalized exercise programs. This is justified by the fact that supervision includes input from a knowledgeable and experienced therapist who is able to plan and implement an exercise program that would address the patient’s needs without introducing any new concerns such as placing the baby at risk or straining the muscles. Based on its results, the article recommends that pregnant women should be subjected to exercise programs that strengthen the muscles around the pelvis and spine to reduce the incidence of lower back pain (Teyhen, 2014). Figueira et al. (2014) similarly note that back pain is a source of concern among pregnant women, and proposes that exercises focusing on flexibility should be implemented to improve posture and pain relief. Relying in a clinical prospective randomized controlled trial that recruited 40 pregnant women, the study determined that static exercises reduce and prevent pregnancy-related lower back pain. This led to the recommendation that pregnant women should be subjected to exercises as part of standard care to reduce the incidence of lower back pain (Figueira et al., 2014). The two articles both provide evidence to support the management of pregnancy-related lower back pain using exercises as a nursing intervention.
EBP Contribution to Outcomes
The evidence-based practice is the nursing personnel should use of low-impact structured exercises to strengthen the lower back muscles and ensure that they can withstand the strain brought about by pregnancy. Although the exercises are intended to reduce the incidence of back pain, failing to use such exercises or using them in the wrong manner would only worsen the situation by either leaving the back muscles weak and unable to handle the strain from pregnancy, or straining other muscles in the body to cause more pain (Figueira et al., 2014) Exercise to Reduce Pregnancy Back Pain.
Disseminating and implementing the evidence-based practice
Evidence will be presented through presentations, posters, and seminars. The dissemination will entail synthesizing the project details to include results that presenting the information to other nursing personnel and stakeholders. This will allow them to determine the value of the project and results, along with implications for practice. Once the evidence has generated extensive discussion, the next step would be to lobby for changes to standard nursing practice. Any concerns and opposition to practice changes would be addressed through discussions and forums where additional evidence would be presented to explain unclear concepts and notions (Melnyk et al., 2015).
Figueira, H., Vale, R., Rodriguez, W., Figueira, A., Figueira, J. & Dantas, E. (2014). Pregnancy-related low back pain relief after maximum static flexibility program. Health, 6, 2966-2972. doi: 10.4236/health.2014.621335
Laughlin, K. & Cristaudo, J. (2016). Stretching & pregnancy. Pittsburgh, PA: BodyPress.
Melnyk, B. & Fineout- Overholt, E. (2015). Evidence-based practice in nursing and healthcare: a guide to best practice (3rd ed.). Philadelphia, PA: Wolters Kluwer.
Teyhen, S. (ed.) (2014). Pregnancy and low back pain: physical therapy can reduce back and pelvic pain during and after pregnancy. Journal of Orthopaedic & Sports Physical Therapy, 44(7), 474. doi: 10.2519/jospt.2014.0505 Exercise to Reduce Pregnancy Back Pain.
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