Nurses face many challenges in cases of pregnancy loss in addressing both the patient’s physical problems and their emotional and mental needs. Approximately 15 – 20% of all clinically identified pregnancies in the United States result in miscarriage. The physical and mental health concerns of families experiencing pregnancy loss include grieving, potential for depression and the risk of experiencing feelings of loss with subsequent pregnancies. The purpose of this project was to establish a process for providing consistent, high-quality, hospital-wide care for patients and families experiencing a pregnancy loss.

Proposed change:

     The first area of change is the formation of a multidisciplinary team consisting of social workers, physicians, nurses, office staff, chaplains, laboratory managers, and leaders from service areas that included the laboratory, operating room, emergency department, risk management, and women’s service line instituted process improvements. Through questionnaires and interviews, the team identified a need for education and support for the nurses who care for these patients.

   Implementation, outcomes and evaluation:

     The Resolve Through Sharing (RTS) program was made available to assist staff to ensure their competence in providing the desired level of care. The program was offered to nurses throughout the hospital system who encounter patients/families with pregnancy loss. Pre and post tests were given to volunteer participants (N=152) in the program to measure confidence levels using a developed Likert scale. Statistical analysis using a t-test paired sample correlation demonstrated significant differences in all items on the pre and post test nursing confidence measure (p < .0001). The RTS educational session was shown to improve self reported nursing confidence when caring for families who have experienced pregnancy loss.

Implications for nursing practice:

     The formation of a transdisciplinary system wide team facilitates intervention strategies that address the complex issues surrounding perinatal loss and focuses on family outcomes. The implementation of educational offerings to support nursing staff when caring for families experiencing perinatal loss increases self reported nursing confidence. Nursing care for patients and families experiencing pregnancy loss may have impact on the future health of the family. This study supports the use of transdisciplinary teams, evidence based interventions including educational programs to develop nursing confidence in caring for families experiencing perinatal loss. Further intervention studies are needed on specific nursing interventions and behaviors that assist families in the physical and mental recovery after a perinatal loss that address multiple cultures.

Keywords:  

Perinatal Loss

Transdisciplinary Team

Nursing Confidence

Grief