Sunday, June 24, 2012

Title: Transitioning From Traditional Maternity Nursing to Family Centered Maternity Nursing

Woodrow Wilson (Gaylord National Harbor)
Kathleen Kleefisch, DNP, FNP_BC , School of Nursing, Purdue University Calumet, Hammond, IN

Discipline: Professional Issues (PI)

Learning Objectives:
  1. Identify the new skills and knowledge needed by the staff nurses to function successfully in the FCMC environment
  2. Describe the challenges involved in implementation of FCMC from traditional maternity nursing
  3. Analyze the effectiveness of FCMC educational innovation on the nuring staff
Submission Description:
Objective:  Current United States perinatal statistics indicate that maternity care continues to need improvement. Guided by the PARIHS framework, this evidence based project hypothesizes that no practice change will occur unless nurses understand and appreciate the relevance of evidence-based maternity care. A within design was used to address the clinical question, "In the transition to FCMC from traditional maternity care, what is the effect of an educational intervention on the staff nurse's nrusing knowledge of evidence based FCMC as compared to the knowledge of traditional nursing maternity practices?"

Design: The major steps of the project were to (a) identify new skills and knowledge needed by the staff nurses to function successfully and to integrate the new philosophy of FCMC, (b) select through a process of professional consensus the top evidence-based clinical recommendations, (c) design educational modules to increase staff nurses's knowledge of FCMC, and (d) measure knowledge gained, to determine the impact of the educational intervention.  

Patients/Participants: All participants were female staff nurses between the ages of 25 and 65 years, working on the maternity unit: 26 (55.3%) worked on the nursery unit, 19 (40.4%) worked on the postpartum unit, and two (4.3%) were managers on the units.  

Methods: Six pre and post tests were given in online format to assess the participant's knowledge of educational module objectives. Descriptive statistics such as number, mean, and standard diviation was used to analyze demographic data. Paired t-test were used to analyze pre and post test score. A 95% confidence interval was set (p= 0.05).

Implementation Strategies: During a period of three months, nine educational sessions were scheduled and completed. An identical format was followed for each session. The four modules were (a) introduction to FCMC, (b) postpartum assessment/nursing care, (c) newborn assessment/nursing care, and (d) perinatal safety and risk management.

Results: The pre and posttest scores of all the educational modules were compared by calculating a paired-samples t test.  The total mean score on the pretest was 0.57 (SD = 0.10). The total mean score on posttest was 0.90 (SD = 0.065). These results exhibted a significant difference in test scores (t (46) = -28.426, p < .000).

Conclusion/Implications for nursing practice: The provision of expert facilitated evidence-based education, guided by the PARIHS framework which considers evidence, context, and facillation can be an impetus for change in healthcare practice. An innovative educational program tailored to the learning needs of experience staff nurses can contribute to improvement in evidence-based nursing practice and patient care.

Keywords: PARIHS framework, Family Centered Maternity Care, educational modules, maternity nursing