APN-Physician Collaboration in Caring for Women With High-Risk Pregnancies
Article first published online: 11 MAY 2005
Journal of Nursing Scholarship
Volume 37, Issue 2, pages 178–184, June 2005
How to Cite
Brooten, D., Youngblut, J., Blais, K., Donahue, D., Cruz, I. and Lightbourne, M. (2005), APN-Physician Collaboration in Caring for Women With High-Risk Pregnancies. Journal of Nursing Scholarship, 37: 178–184. doi: 10.1111/j.1547-5069.2005.00002.x
- Issue published online: 11 MAY 2005
- Article first published online: 11 MAY 2005
- Accepted for publication October 6, 2004.
- APN-physician collaboration;
- high-risk pregnancy;
- transitional care;
- advanced practice nurses
Purpose: To examine: (a) frequency and focus of APN-physician collaborations in a clinical trial in which half of physician prenatal care for women with high-risk pregnancies was substituted with APN prenatal care delivered in women's homes; and (b) characteristics of women requiring greater numbers of collaborations.
Design and Methods: Descriptive study with secondary analysis of data from 83 of the original trial's 85 intervention participants followed by APNs prenatally through 8 weeks postpartum. APN practices, recorded in logs, included APN interactions with the women and the physician, and type of APN contact (e.g., home visit, telephone call). Each APN-physician collaboration was coded for type, timing, and focus.
Findings: Total number of APN-physician collaboration contacts was 351, with a mean of 4.5 and a range of 1 to 16 per woman. Focus of collaborations was: status updates (59%), new physical findings (21%), change in treatment (8%), patient concerns (7%) and medication adjustment (5%). No significant differences in numbers of collaborations were found according to age, primary diagnosis, marital status, type of health insurance, race, or income. Women with high school education received more collaborations than did those not completing high school or those with some postsecondary education. Prenatally, women with a first pregnancy required more collaborations than did multipara participants.
Conclusions: Most APN-physician collaborative contacts were focused on monitoring women's physical and emotional status and discussing new physical findings. These collaborations were important in the original trial's successful pregnancy and infant outcomes and savings in health care dollars.