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Six Principles for the Long-Term Antepartum Patient: A Care Model From the Heartland
Hendricksmeyer, K. A., Maeder, P. A. and Serbousek, S. E.
INNOVATIVE PROGRAMS Proceedings of the 2010 AWHONN Annual Convention
Six Principles for the Long-Term Antepartum Patient: A Care Model From the Heartland Poster Presentation Kathleen A. Hendricksmeyer, RN, Birthcare Center, St. Luke’s Hospital, Cedar Rapids, IA
t. Luke’s is a 540-bed hospital serving Cedar Rapids and surrounding areas in eastern Iowa. We average 250 births per month. In 2001, we opened a Women’s and Children’s Center in which family-centered maternity care was the focus. This gave us the opportunity to build an antepartum wing to our speci¢cations.
S
Phyllis Ann Maeder, BSN, RNC, Birthcare Center, St. Luke’s Hospital, Cedar Rapids, IA
Sarah E. Serbousek, RN, Birthcare Center, St. Luke’s
We are presenting a poster that re£ects six principles for a model of care that has improved our antepartum patient and family outcomes. The principles are centralization, education, coordination, personalization, documentation, and evaluation.
Hospital, Cedar Rapids, IA
Childbearing
Centralization: Having a separate wing of ¢ve rooms allows for a quieter environment promoting rest and providing more privacy for our families. This also allows space for our patients to support each other. Education: A series of written pamphlets were developed that help with orientation to our unit and explain what to expect during the hospitalization. One-on-one prenatal classes are o¡ered as are a variety of videos and DVD’s. An antepartum journal was organized and sent to the March of Dimes for publication. Coordination: Dietitians, lactation consultants, neonatologists, recreation therapy, pet therapy, massage therapy, pastoral care, volunteer services, and on-site social workers are working to meet the needs of our patients. A care conference every day Monday through Friday includes the nurses, social worker, dietary, charge nurse, and insurance coordinator. Other members of the team attend as
JOGNN 2010; Vol. 39, Supplement 1
needed. Physician and family members attending are in the planning stage. Personalization: Treating patients as unique individuals means looking beyond this pregnancy to their other roles as wife, mother, girlfriend, and woman. Families and friends are encouraged to visit with their children, and family members spend the night. We recognize that special occasions occur and provide rooms for the celebrations. The patients have computer and Internet access upon their request. Documentation: A series of £ow sheets were developed for antepartum diagnoses, and our kardex is invaluable in communication medication schedules and changes in the plan of care. Each week we do an ‘‘o⁄ce visit’’ tracking weight gain, fundal height, and urine analysis. Evaluation: All our e¡orts are geared toward easing the stress of prolonged antepartum hospitalization. The antepartum patient is visited frequently by management/care coordinators. The plan of care is revised when needed. The antepartum committee meets bimonthly to work on issues and plan improvements. Press Ganey surveys are sent to all patients, and the results reviewed for patient input. Caring for the antepartum patient has become a specialty in our birthing center. A core group of nurses is dedicated to easing the e¡ects of longterm hospitalization. Using these six principles we strive to decrease the stress of separation from family, anxiety about the high-risk pregnancy, and fear for the health of the unborn child. We also try to provide a home-like environment and encourage patients to actively participate in their plans of care.
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INNOVATIVE PROGRAMS Proceedings of the 2010 AWHONN Annual Convention
Six Principles for the Long-Term Antepartum Patient: A Care Model From the Heartland Poster Presentation Kathleen A. Hendricksmeyer, RN, Birthcare Center, St. Luke’s Hospital, Cedar Rapids, IA
t. Luke’s is a 540-bed hospital serving Cedar Rapids and surrounding areas in eastern Iowa. We average 250 births per month. In 2001, we opened a Women’s and Children’s Center in which family-centered maternity care was the focus. This gave us the opportunity to build an antepartum wing to our speci¢cations.
S
Phyllis Ann Maeder, BSN, RNC, Birthcare Center, St. Luke’s Hospital, Cedar Rapids, IA
Sarah E. Serbousek, RN, Birthcare Center, St. Luke’s
We are presenting a poster that re£ects six principles for a model of care that has improved our antepartum patient and family outcomes. The principles are centralization, education, coordination, personalization, documentation, and evaluation.
Hospital, Cedar Rapids, IA
Childbearing
Centralization: Having a separate wing of ¢ve rooms allows for a quieter environment promoting rest and providing more privacy for our families. This also allows space for our patients to support each other. Education: A series of written pamphlets were developed that help with orientation to our unit and explain what to expect during the hospitalization. One-on-one prenatal classes are o¡ered as are a variety of videos and DVD’s. An antepartum journal was organized and sent to the March of Dimes for publication. Coordination: Dietitians, lactation consultants, neonatologists, recreation therapy, pet therapy, massage therapy, pastoral care, volunteer services, and on-site social workers are working to meet the needs of our patients. A care conference every day Monday through Friday includes the nurses, social worker, dietary, charge nurse, and insurance coordinator. Other members of the team attend as
JOGNN 2010; Vol. 39, Supplement 1
needed. Physician and family members attending are in the planning stage. Personalization: Treating patients as unique individuals means looking beyond this pregnancy to their other roles as wife, mother, girlfriend, and woman. Families and friends are encouraged to visit with their children, and family members spend the night. We recognize that special occasions occur and provide rooms for the celebrations. The patients have computer and Internet access upon their request. Documentation: A series of £ow sheets were developed for antepartum diagnoses, and our kardex is invaluable in communication medication schedules and changes in the plan of care. Each week we do an ‘‘o⁄ce visit’’ tracking weight gain, fundal height, and urine analysis. Evaluation: All our e¡orts are geared toward easing the stress of prolonged antepartum hospitalization. The antepartum patient is visited frequently by management/care coordinators. The plan of care is revised when needed. The antepartum committee meets bimonthly to work on issues and plan improvements. Press Ganey surveys are sent to all patients, and the results reviewed for patient input. Caring for the antepartum patient has become a specialty in our birthing center. A core group of nurses is dedicated to easing the e¡ects of longterm hospitalization. Using these six principles we strive to decrease the stress of separation from family, anxiety about the high-risk pregnancy, and fear for the health of the unborn child. We also try to provide a home-like environment and encourage patients to actively participate in their plans of care.
S25