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St. 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.  Family Centered Maternity Care was the focus.  This gave us the opportunity to build an antepartum wing to our specifications. 

We are presenting a poster that reflects 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.

Centralization.  Having a separate wing of five 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 offered 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 toward the needs of our patients.  There is a care conference every day Monday through Friday.  This includes the nurses, social worker, dietary, charge nurse and insurance coordinator.  Other members of the team attend as 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 flow 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 “office visit” tracking weight gain, fundal height and urine analysis. 

 Evaluation.  All our efforts 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.  We have a core group of nurses dedicated to easing the effects of long term 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 plan of care.