Curiosity

Curiosity - include information from your PICOT project in NRN 57. Why did you choose the skill? What new information did you learn?

In the second semester, I implemented "Curiosity" many times throughout the situation, however, the PICOT project is the greatest example. To summarize my picot paper, I conducted research to compare the methods of administering antibiotics 4 hours before labor and administering antibiotics during labor. Based on the evidence that I have found, I determine that the intervention of administering antibiotics during labor is probably helpful. Starting antibiotic prophylaxis 4 hours before has a greater than 85% chance in preventing GBS infection. However, based on the research I've conducted, administering during labor has a slightly higher efficacy than administering before labor. Medical advancements will need to be made to further decrease the chances of the neonatal mortality due to GBS. As stated above, screening tests at 36-37 weeks may not be accurate as positive GBS infection can be resolved during the time of labor. Similarly, negative results may become positive at the time of labor. Due to this, rapid screening should also be reintroduced as a screening tool during labor so that women and the newborns will not have to receive unnecessary antibiotic treatment. My advice for others who may conduct research on a PICOT question is to pick one from a clinical experience since that may facilitate your learning. 

Why I chose this paper: During my OB rotation, I was assigned to a mother who tested positive for GBS. I asked the nurse about the facility's protocol of treating GBS, to which she replied that they administer 4 hours before labor. I was curious about this method, so I took time to search GBS treatment methods. To my surprise, I found that this is actually NOT per the CDC recommended guidelines of administering antibiotics during labor. The discrepancy between the hospital practice and the CDC recommendation led me to my research topic.