Current practice in oxytocin dilution and fluid administration for induction of labor.

Abstract

To determine the types of intravenous fluids used to dilute oxytocin for labor induction in a national sample of obstetric units, as well as the extent to which these fluids reflect current published guidelines. A descriptive design. Questionnaires were mailed to nurse managers at 700 obstetric units chosen via systematic random sampling from eligible hospitals listed in The AHA Guide (1998). Two hundred fifty-six usable questionnaires were included in data analysis. The Labor Induction Protocol Survey, consisting of eight questions relating to number of births per year, percentage of women whose labor is induced or augmented, methods used for induction of labor, intravenous fluids used to dilute oxytocin for induction of labor, the level of perinatal care of the unit, and the protocols units used to guide their practice in the use of oxytocin, was developed for this study. Approximately 98% of the responding sites follow the current recommendations for oxytocin dilution and mainline fluid delivery. However, 5 or 2% of the sites reported the use of 5% dextrose in water for both oxytocin dilution and the mainline intravenous solution. Although only 5 (2%) of the responding facilities indicated the use of 5% dextrose in water for both oxytocin dilution and the mainline intravenous solution, this may be clinically significant because of the serious nature of hyponatremia and the ease of its prevention. Nurses should be aware of the extent to which protocols for the infusion of oxytocin vary, despite what is documented as best practice and the potential consequences for their patients of implementing those protocols. Nurses who advocate for and participate in writing protocols that reflect the best-recommended practice for their patients will assist in ensuring that what is documented as best practice is actually implemented.