Bridging the Gaps Across the Continuum for Pregnant Women at Risk for Preterm Birth
Version of Record online: 14 JUN 2012
© 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses
Journal of Obstetric, Gynecologic, & Neonatal Nursing
Special Issue: 2012 Convention Proceedings
Volume 41, Issue s1, pages S26–S27, June 2012
How to Cite
Pehanich, K. and Dieme, D. (2012), Bridging the Gaps Across the Continuum for Pregnant Women at Risk for Preterm Birth. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 41: S26–S27. doi: 10.1111/j.1552-6909.2012.01359_34.x
- Issue online: 14 JUN 2012
- Version of Record online: 14 JUN 2012
- preterm labor;
- preterm birth;
- cervical length
Purpose for the Program
Preterm birth is the leading cause of newborn death in the United States. In Colorado, one in eight infants is born prematurely. Preterm birth accounts for 70% of neonatal mortality, morbidity, and health care dollars spent on newborns, with national annual costs totaling more than $26.2 billion. St. Anthony North Hospital is collaborating with community stakeholders to identify strategies that can be implemented across the continuum of care to positively affect women at risk of preterm birth.
To increase quality, decrease cost, and increase satisfaction for patients at risk of preterm labor, nursing staff, and physicians across the continuum.
Implementation, Outcomes, and Evaluation
Community stakeholders were gathered to work on the project. Process mapping from nursing, clinic, and patient perspectives was completed to evaluate risk or failure points as the patient traveled through the continuum of care. Clinician satisfaction surveys also were collected. Clinical variances were identified with regard to assessment and treatment of preterm labor as well as patient education and coordination of care. Standardized definitions, guidelines, and orders are being developed to aid in early identification and treatment of preterm labor. Patient educational materials were designed for utilization across the continuum. Teach-back was implemented to assess patient knowledge of the care plan. Coordination of care and communication between providers were streamlined to convey assessment findings, interventions, and medications; pending tests; care needs; follow-up appointments; and resources to aid in the coordination of care between providers. A process also was developed for the safe transport of patients at greatest risk of preterm delivery to more appropriate levels of neonatal care. Data collection is currently underway. Anticipated results include a decreased triage time; decreased observation admissions for preterm labor; decreased cost triage and hospital costs; increased patient, nurse, and physician satisfaction; and an improved rate of antenatal steroid administration.
Implications for Nursing Practice
Coordination of care with community stakeholders across the continuum of care can improve outcomes for women at risk of preterm birth by early identification of risk, improved handoff communication, and decreased utilization of health care resources.