Implementing a Nurse Navigation Program for High Risk Obstetric Patients: An Evidence-Based Practice Approach
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 S89–S90, June 2012
How to Cite
Langheld, S. G. (2012), Implementing a Nurse Navigation Program for High Risk Obstetric Patients: An Evidence-Based Practice Approach. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 41: S89–S90. doi: 10.1111/j.1552-6909.2012.01361_51.x
- Issue online: 14 JUN 2012
- Version of Record online: 14 JUN 2012
- nurse navigation;
- high-risk obstetrics;
- patient navigation;
Purpose for the Program
Nurse navigation has become an important part of many oncology centers and is an emerging trend that has been used to increase patient satisfaction, improve outcomes, and decrease barriers to care. Navigation programs can be implemented and operationalized differently depending on the practice setting.
The obstetric high-risk nurse navigation program provides complex obstetric patients with specialized education, patient advocacy, follow-up, support, and coordination of care in today's complex health care setting. Time constraints, increasing documentation, and the rising complexity of patients mean less time with the maternal–child nurse and her providers. Because of this identified need, a multidisciplinary council visualized applying the navigation concept to maternity care. The purpose and primary goals for creation of the program were to develop standardized high-risk patient education forms with recommendations and to provide an accurate follow-up summary for patients experiencing a high-risk pregnancy. The summary becomes part of the medical record to ensure accurate information and timely retrieval of obstetric history with return to care in subsequent pregnancies.
Implementation, Outcomes, and Evaluation
The program was implemented after the development and standardization of patient information with the guidance from maternal–fetal medicine with two tiers of 15 high-risk conditions. An emphasis of the program design was educating patients about disease processes that affect health and complicate future pregnancies. A computerized system for referral, tracking, and documentation was developed. After a referral is received, education and recommendations are given to the patient postpartum. Follow-up care is provided and a comprehensive summary form is completed. The patient benefits from a cultivated relationship with the navigator who serves as a contact person and as a liaison between providers. The program design complements the continuum of care and identifies high-risk conditions that affect postpartum care, the interconception interval, and subsequent pregnancies. Navigator use in obstetrics can ensure that the high-risk patient has dedicated follow-up care after discharge through preconception.
Implications for Nursing Practice
By examining the role of the nurse navigator depicted in literature and its successful application to oncology units, we can benefit from its use in maternal–child nursing. Patient navigation is an emerging trend that can be applied to obstetrics to play a significant role in increasing patient, nurse, and provider satisfaction.