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.

Proposed change: The Obstetrical High Risk Nurse Navigation program at Caromont Healthcare In Gastonia, NC provides complex obstetrical patients with specialized education, patient advocacy, follow up, support and coordination of care in today’s complex healthcare 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 obstetrical 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 fifteen high risk conditions.  An emphasis of the program design was educating patients about disease processes that impact 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 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 compliments the continuum of care that is maternal-child nursing and identifies high risk conditions that impact postpartum care, the interconception interval and subsequent pregnancies. Navigator use in obstetrics can ensure the high risk patient had 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 and can be lateralized to obstetrics to play a significant role in increasing patient, nurse and provider satisfaction.

Keywords: Nurse Navigation, High Risk Obstetrics, Patient Navigation, Implementing