- Email: [email protected]
Perinatal Mood Disorders: Implementation of a Hospital-Based Screening Program
INNOVATIVE PROGRAMS Proceedings of the 2011 AWHONN Convention
gram was used as the primary source for the educational content. A Likert-style comfort scoring tool was created which assessed participants’ comfort levels with various aspects of labor and delivery, postpartum, and well-baby care. A 50 question test was developed using sample questions pulled from the self-study books. Chart audit tools were developed to assess basic knowledge and skill level. A luncheon was held at the Level I center and the program objectives were shared with each participant as well as nursing leadership. The test, comfort tool, and chart audits were also completed at this luncheon. For a total of 11 weeks, participants completed course work and submitted tests at the completion of each module. During this time, the program developers traveled to the Level I facility and performed skills sessions and critical thinking exercises. Upon completion of the required 11 weeks of coursework, the four participants spent 2 weeks (six 12-hour shifts) of clinical time working in the L&D, neonatal intensive care unit (NICU), and well-
baby nursery, with the program developers serving as preceptors. After completing the 2 week clinical rotation of the fellowship program, the participants completed the posttest and comfort tool (the same tools were used for pre- and posttesting).
Mindy Spencer, RNC-NIC,
There was a dramatic increase in the knowledge base of the participants as evidenced by improvement on the posttests. Comfort levels, assessed using the Likert scoring method also drastically increased.
Keywords perinatal nurses self-study education community training
The program developers recognized a need for a more streamlined data collection process. The participants requested that the program developers provide more hands-on training before the clinical rotation at the RPC.
BSN, Perinatal Outreach Education, Phoebe Putney Memorial Hospital, Albany, GA
Professional Issues
Implications for Nursing Practice Using the self-study method allowed valuable classroom time to be spent on performing handson critical thinking activities.
Perinatal Mood Disorders: Implementation of a Hospital-Based Screening Program Poster Presentation Purpose for the Program ow can the mother-baby nurse initiate a realistic screening process to identify women at risk for perinatal mood disorders and what support services can we o¡er?
H
Proposed Change To develop a realistic screening and referral process that empowers the mother-baby nurse to assess and refer a mother who has the potential of developing a perinatal mood disorder to home care for continued assessment and evaluation after discharge. Implementation, Outcomes, and Evaluation The Perinatal Mood Disorder Project was developed based on an identi¢ed gap in services or follow-up in the community for women at risk for perinatal mood disorders. The nursing sta¡ collaborated with senior leadership, administration, and the Home Care Department to determine the feasibility of developing a nurse driven home care
S44
referral process. When patients arrive at the mother-baby unit, the nursing admission assessment includes a simple screening tool utilizing three questions. A positive response to one question regarding personal or family history of psychiatric illness triggers a referral to social work, £agging the chart for the obstetrician and pediatrician, and a direct home care referral. The home care intake nurse meets with the mother before discharge. The patient makes the decision regarding participation in the follow-up program. A telephonic screen is conducted by the home care social worker 4 to 5 weeks later. A home visit occurs 24 to 48 hours later based upon patient assessment and obtaining a physician order. A physical and psychosocial assessment is performed, education and emotional support provided, and community services and referrals are arranged.
Mary Lynn Brassil, MS, RN, CES, Winthrop University Hospital, Mineola, NY
Eileen Magri, MSN, RN, NEBC, Winthrop University Hospital, Mineola, NY
Anne Calvo, RN, BSN, MPS, Winthrop University Hospital, Mineola, NY
Alissa Adamo, LCSW, Winthrop University Hospital, Mineola, NY
Loretta Gambino, LMSW,
Since the initiation of the program in March of 2008 more than 1581 nurse driven referrals were generated, 1014 telephone assessments and 182 home visits made and psychiatric intervention increased by 33%. The Perinatal Mood Disorder program has been well received by mothers, families, and the medical community and has proven to be an e¡ec-
JOGNN, 40, S2-S84; 2011. DOI: 10.1111/j.1552-6909.2011.01242.x
Winthrop University Hospital, Mineola, NY
Netta Waters, RN, BSN, Winthrop University Hospital, Mineola, NY
http://jognn.awhonn.org
INNOVATIVE PROGRAMS
Brice, L. M.
Proceedings of the 2011 AWHONN Convention
Keywords perinatal mood disorders hospital screening home care
Professional Issues
tive and realistic strategy for identifying women at risk and providing follow-up care. Implications for Nursing Practice The screening of all patients upon admission to the mother-baby unit and subsequent referrals has become standard of care. Nursing leadership is at the core of this program as demonstrated by the sta¡s’ ability to initiate e¡ective change
management related to an issue the bedside nurse identi¢ed. The sta¡ demonstrated professionalism in the commitment to evidence-based clinical and management practice. Nurse leadership in this often undiagnosed disorder has provided awareness to the entire health care team and certainly has in£uenced how patients are managed.
Sex and the City: Developing a Comprehensive Sex Education Program for a Very Conservative, ‘‘Abstinence Only’’ Community Poster Presentation Linda M. Brice, RN, PhD, Anita Thigpen Perry School of Nursing, Texas Tech University Health Sciences Center, Lubbock, TX
Keywords community wide comprehensive sex education program
Professional Issues
Purpose for the Program exas has some of the highest rates of teen pregnancy, sexually transmitted diseases (STDs), low birth weight babies, preterm births, infant mortality, neonatal complications, and child sexual and physical abuse in the United States. One conservative west Texas community has many of the highest rates of these perinatal problems not only inTexas, but also in the United States. Many community health and educational leaders believe that one reason for these multiple health concerns is the requirement of teaching abstinence only education in high schools. Teens and preteens are not learning about how their bodies work, about sex and pregnancy, protection (condoms) and contraception, or responsibilities and consequences of being sexually active. Furthermore, many parents, grandparents, foster parents, youth leaders, teachers, and other adults do not feel they are adequately prepared or knowledgeable to talk with their children about these topics.
T
Proposed Change After many years of rising rates, increased tax dollars spent, and lives of teens and their infants in turmoil, health care professionals in this community took action to start a comprehensive, communitywide, sex education program called Teen Straight Talk for adults and their adolescents (ages 1-18). It is a community-based program supported by more
JOGNN 2011; Vol. 40, Supplement 1
than 60 community organizations, businesses, and individuals. Implementation, Outcomes, and Evaluation The goal of Teen Straight Talk is to start a dialogue between parents, other adults, teens, and even preteens on sexual health topics including, male and female anatomy, how the body works, what is an STD, abstinence, the responsibilities and consequences of being sexually active and how to protect oneself from contracting an STD or becoming pregnant. A second part of the program deals with such teen problems as peer pressure, body image and eating disorders, depression and suicides, drug and alcohol abuse, and how teens can relate to teen pregnancies and STDs. Implications for Nursing Practice This program is presented by health care professionals including nursing faculty, nursing students, nurses and nurse practitioners, obstetric/gynecologic (OB/GYN) physicians and residents, and medical students. This paper presentation will explain how the program was established and how any community can take similar action. Research is currently being conducted on this program, and it has received local and national funding and awards. The program is being expanded to better serve the community and decrease the high rate of teen pregnancy and STDs.
S45
gram was used as the primary source for the educational content. A Likert-style comfort scoring tool was created which assessed participants’ comfort levels with various aspects of labor and delivery, postpartum, and well-baby care. A 50 question test was developed using sample questions pulled from the self-study books. Chart audit tools were developed to assess basic knowledge and skill level. A luncheon was held at the Level I center and the program objectives were shared with each participant as well as nursing leadership. The test, comfort tool, and chart audits were also completed at this luncheon. For a total of 11 weeks, participants completed course work and submitted tests at the completion of each module. During this time, the program developers traveled to the Level I facility and performed skills sessions and critical thinking exercises. Upon completion of the required 11 weeks of coursework, the four participants spent 2 weeks (six 12-hour shifts) of clinical time working in the L&D, neonatal intensive care unit (NICU), and well-
baby nursery, with the program developers serving as preceptors. After completing the 2 week clinical rotation of the fellowship program, the participants completed the posttest and comfort tool (the same tools were used for pre- and posttesting).
Mindy Spencer, RNC-NIC,
There was a dramatic increase in the knowledge base of the participants as evidenced by improvement on the posttests. Comfort levels, assessed using the Likert scoring method also drastically increased.
Keywords perinatal nurses self-study education community training
The program developers recognized a need for a more streamlined data collection process. The participants requested that the program developers provide more hands-on training before the clinical rotation at the RPC.
BSN, Perinatal Outreach Education, Phoebe Putney Memorial Hospital, Albany, GA
Professional Issues
Implications for Nursing Practice Using the self-study method allowed valuable classroom time to be spent on performing handson critical thinking activities.
Perinatal Mood Disorders: Implementation of a Hospital-Based Screening Program Poster Presentation Purpose for the Program ow can the mother-baby nurse initiate a realistic screening process to identify women at risk for perinatal mood disorders and what support services can we o¡er?
H
Proposed Change To develop a realistic screening and referral process that empowers the mother-baby nurse to assess and refer a mother who has the potential of developing a perinatal mood disorder to home care for continued assessment and evaluation after discharge. Implementation, Outcomes, and Evaluation The Perinatal Mood Disorder Project was developed based on an identi¢ed gap in services or follow-up in the community for women at risk for perinatal mood disorders. The nursing sta¡ collaborated with senior leadership, administration, and the Home Care Department to determine the feasibility of developing a nurse driven home care
S44
referral process. When patients arrive at the mother-baby unit, the nursing admission assessment includes a simple screening tool utilizing three questions. A positive response to one question regarding personal or family history of psychiatric illness triggers a referral to social work, £agging the chart for the obstetrician and pediatrician, and a direct home care referral. The home care intake nurse meets with the mother before discharge. The patient makes the decision regarding participation in the follow-up program. A telephonic screen is conducted by the home care social worker 4 to 5 weeks later. A home visit occurs 24 to 48 hours later based upon patient assessment and obtaining a physician order. A physical and psychosocial assessment is performed, education and emotional support provided, and community services and referrals are arranged.
Mary Lynn Brassil, MS, RN, CES, Winthrop University Hospital, Mineola, NY
Eileen Magri, MSN, RN, NEBC, Winthrop University Hospital, Mineola, NY
Anne Calvo, RN, BSN, MPS, Winthrop University Hospital, Mineola, NY
Alissa Adamo, LCSW, Winthrop University Hospital, Mineola, NY
Loretta Gambino, LMSW,
Since the initiation of the program in March of 2008 more than 1581 nurse driven referrals were generated, 1014 telephone assessments and 182 home visits made and psychiatric intervention increased by 33%. The Perinatal Mood Disorder program has been well received by mothers, families, and the medical community and has proven to be an e¡ec-
JOGNN, 40, S2-S84; 2011. DOI: 10.1111/j.1552-6909.2011.01242.x
Winthrop University Hospital, Mineola, NY
Netta Waters, RN, BSN, Winthrop University Hospital, Mineola, NY
http://jognn.awhonn.org
INNOVATIVE PROGRAMS
Brice, L. M.
Proceedings of the 2011 AWHONN Convention
Keywords perinatal mood disorders hospital screening home care
Professional Issues
tive and realistic strategy for identifying women at risk and providing follow-up care. Implications for Nursing Practice The screening of all patients upon admission to the mother-baby unit and subsequent referrals has become standard of care. Nursing leadership is at the core of this program as demonstrated by the sta¡s’ ability to initiate e¡ective change
management related to an issue the bedside nurse identi¢ed. The sta¡ demonstrated professionalism in the commitment to evidence-based clinical and management practice. Nurse leadership in this often undiagnosed disorder has provided awareness to the entire health care team and certainly has in£uenced how patients are managed.
Sex and the City: Developing a Comprehensive Sex Education Program for a Very Conservative, ‘‘Abstinence Only’’ Community Poster Presentation Linda M. Brice, RN, PhD, Anita Thigpen Perry School of Nursing, Texas Tech University Health Sciences Center, Lubbock, TX
Keywords community wide comprehensive sex education program
Professional Issues
Purpose for the Program exas has some of the highest rates of teen pregnancy, sexually transmitted diseases (STDs), low birth weight babies, preterm births, infant mortality, neonatal complications, and child sexual and physical abuse in the United States. One conservative west Texas community has many of the highest rates of these perinatal problems not only inTexas, but also in the United States. Many community health and educational leaders believe that one reason for these multiple health concerns is the requirement of teaching abstinence only education in high schools. Teens and preteens are not learning about how their bodies work, about sex and pregnancy, protection (condoms) and contraception, or responsibilities and consequences of being sexually active. Furthermore, many parents, grandparents, foster parents, youth leaders, teachers, and other adults do not feel they are adequately prepared or knowledgeable to talk with their children about these topics.
T
Proposed Change After many years of rising rates, increased tax dollars spent, and lives of teens and their infants in turmoil, health care professionals in this community took action to start a comprehensive, communitywide, sex education program called Teen Straight Talk for adults and their adolescents (ages 1-18). It is a community-based program supported by more
JOGNN 2011; Vol. 40, Supplement 1
than 60 community organizations, businesses, and individuals. Implementation, Outcomes, and Evaluation The goal of Teen Straight Talk is to start a dialogue between parents, other adults, teens, and even preteens on sexual health topics including, male and female anatomy, how the body works, what is an STD, abstinence, the responsibilities and consequences of being sexually active and how to protect oneself from contracting an STD or becoming pregnant. A second part of the program deals with such teen problems as peer pressure, body image and eating disorders, depression and suicides, drug and alcohol abuse, and how teens can relate to teen pregnancies and STDs. Implications for Nursing Practice This program is presented by health care professionals including nursing faculty, nursing students, nurses and nurse practitioners, obstetric/gynecologic (OB/GYN) physicians and residents, and medical students. This paper presentation will explain how the program was established and how any community can take similar action. Research is currently being conducted on this program, and it has received local and national funding and awards. The program is being expanded to better serve the community and decrease the high rate of teen pregnancy and STDs.
S45