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Patients in the Antepartum Period: Our Most Important Patients
I N N O VAT I V E P R O G R A M S
Ratto, C. M. and Huwe, V. Y.
Proceedings of the 2013 AWHONN Convention
Stacy Murphy, BSN, RN, White Plains Hospital, White Plains, NY Keywords discharge nurse patient satisfaction HCAHPS scores standardization nurse satisfaction
Childbearing Paper Presentation
including the effects of medication and potential adverse effects, review and prepare necessary paperwork, review discharge instructions for the mom and infant, review all screening tests and results, and review follow-up appointments for the mom and infant. Patients discharged in the coming day or days would attend a daily parent education class taught by the DN. The final car seat check would also be executed by the DN. After the mom and infant were discharged, the DN would document the discharge and complete the process. Implementation, Outcomes, and Evaluation The position was trialed for 3 months and made permanent late spring 2012 after evaluation of outcomes were realized. Press Ganey as well as HCAHP scores validated an increase in patient
satisfaction with the discharge process and patient education class time. The hospital administration recognized the positive outcomes and is presently using this best practice on another unit. Implications for Nursing Practice This innovative program can be used on any unit struggling with discharge-related patient satisfaction scores. The efficiency gained as a result of this process can be extrapolated for admission as well, and an admission and discharge team can be used to generate improved satisfaction in addition to improved throughput between units. Standardization ensures that the education surrounding discharge of mothers and newborns is consistent from one patient to the next. Nurse satisfaction was improved from this process and left more time for the staff nurse to monitor, care for, and teach patients with less fragmentation.
Patients in the Antepartum Period: Our Most Important Patients Purpose for the Program o address the need for structured programs and consistent nursing care to improve the Valerie Yates Huwe, RNC-OB, experience of hospitalized patients in the anteparMS, CNS, UCSF Benioff tum period.
during their antepartum period and now have infants in the neonatal intensive care unit (NICU) to come to the tea party and share their own NICU experience.
Children’s Hospital, San Francisco, CA
Implementation, Outcomes, and Evaluation Implementation of the program relies on one person to be the administrator with the SPCA and the co-facilitator (along with one of our perinatal social workers) for the tea party. The bedside nurses can initiate other interventions. We have found that the interaction between mothers meeting at our tea party is enough of an introduction that they continue to contact one another either by phone, e-mail, or visiting one another’s room. Patient satisfaction is important to us and we are working on a method to conduct posthospitalization interviews to find out if patients were able to cope better with their hospitalization after our interventions.
Christine M. Ratto, MSN, RN, RNC-OB, UCSF, San Francisco, CA
Keywords antepartum patients stressor coping collaboration needs
Childbearing Paper Presentation
T
Proposed Change To initiate program interventions that affect the ability of a patient in the antepartum period to cope and feel less lonely in her prolonged hospitalization. Collaborate with the local American Society for the Prevention of Cruelty to Animals (SPCA) to bring in therapy dogs for weekly visits. Collaborate with the spiritual care department to provide opportunities individualized for each patient in the antepartum period: offer meditation; live music through a Music in Medicine program; the ability to work within each family’s faith to have a blessing or good health ritual for the unborn fetus; and weekly tea parties, which bring together patients for a facilitated chat about their hospitalized experience, how to fight the boredom of long days and nights in the hospital, and their hopes and fears for their yet-to-be-born infants. We also invite mothers who were patients
JOGNN 2013; Vol. 42, Supplement 1
Implications for Nursing Practice Women experience loneliness, fear, anxiety, and boredom during bed rest and hospitalization. A nurse’s understanding of this experience is essential to provide adequate care and coping strategies for women at this time.
S5
Ratto, C. M. and Huwe, V. Y.
Proceedings of the 2013 AWHONN Convention
Stacy Murphy, BSN, RN, White Plains Hospital, White Plains, NY Keywords discharge nurse patient satisfaction HCAHPS scores standardization nurse satisfaction
Childbearing Paper Presentation
including the effects of medication and potential adverse effects, review and prepare necessary paperwork, review discharge instructions for the mom and infant, review all screening tests and results, and review follow-up appointments for the mom and infant. Patients discharged in the coming day or days would attend a daily parent education class taught by the DN. The final car seat check would also be executed by the DN. After the mom and infant were discharged, the DN would document the discharge and complete the process. Implementation, Outcomes, and Evaluation The position was trialed for 3 months and made permanent late spring 2012 after evaluation of outcomes were realized. Press Ganey as well as HCAHP scores validated an increase in patient
satisfaction with the discharge process and patient education class time. The hospital administration recognized the positive outcomes and is presently using this best practice on another unit. Implications for Nursing Practice This innovative program can be used on any unit struggling with discharge-related patient satisfaction scores. The efficiency gained as a result of this process can be extrapolated for admission as well, and an admission and discharge team can be used to generate improved satisfaction in addition to improved throughput between units. Standardization ensures that the education surrounding discharge of mothers and newborns is consistent from one patient to the next. Nurse satisfaction was improved from this process and left more time for the staff nurse to monitor, care for, and teach patients with less fragmentation.
Patients in the Antepartum Period: Our Most Important Patients Purpose for the Program o address the need for structured programs and consistent nursing care to improve the Valerie Yates Huwe, RNC-OB, experience of hospitalized patients in the anteparMS, CNS, UCSF Benioff tum period.
during their antepartum period and now have infants in the neonatal intensive care unit (NICU) to come to the tea party and share their own NICU experience.
Children’s Hospital, San Francisco, CA
Implementation, Outcomes, and Evaluation Implementation of the program relies on one person to be the administrator with the SPCA and the co-facilitator (along with one of our perinatal social workers) for the tea party. The bedside nurses can initiate other interventions. We have found that the interaction between mothers meeting at our tea party is enough of an introduction that they continue to contact one another either by phone, e-mail, or visiting one another’s room. Patient satisfaction is important to us and we are working on a method to conduct posthospitalization interviews to find out if patients were able to cope better with their hospitalization after our interventions.
Christine M. Ratto, MSN, RN, RNC-OB, UCSF, San Francisco, CA
Keywords antepartum patients stressor coping collaboration needs
Childbearing Paper Presentation
T
Proposed Change To initiate program interventions that affect the ability of a patient in the antepartum period to cope and feel less lonely in her prolonged hospitalization. Collaborate with the local American Society for the Prevention of Cruelty to Animals (SPCA) to bring in therapy dogs for weekly visits. Collaborate with the spiritual care department to provide opportunities individualized for each patient in the antepartum period: offer meditation; live music through a Music in Medicine program; the ability to work within each family’s faith to have a blessing or good health ritual for the unborn fetus; and weekly tea parties, which bring together patients for a facilitated chat about their hospitalized experience, how to fight the boredom of long days and nights in the hospital, and their hopes and fears for their yet-to-be-born infants. We also invite mothers who were patients
JOGNN 2013; Vol. 42, Supplement 1
Implications for Nursing Practice Women experience loneliness, fear, anxiety, and boredom during bed rest and hospitalization. A nurse’s understanding of this experience is essential to provide adequate care and coping strategies for women at this time.
S5