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A Hospital Based, Healthy Pregnancy Promotion Program to Empower the Socially At Risk: The Healthy Beginnings Program
Title: A Hospital Based, Healthy Pregnancy Promotion Program to Empower the Socially At Risk: The Healthy Beginnings Program
- Describe the difference in outcomes between women enrolled in the Healthy Beginnings Program and those not in the program, but of a similar client base.
- Discuss the framework used to implement a hospital based, healthy pregnancy promotion program for the socially at risk.
- Identify opportunities to empower women who are at risk for delivering preterm, low birth weight babies.
The Healthy Beginnings Program provides education, support, counseling, and a link to community resources to socially high-risk pregnant women who will deliver at Saint Joseph Medical Center. The purpose is to encourage a healthy lifestyle for every mother, so she will deliver a full-term, healthy newborn.
Eligibility:
• Medicaid patient
• Limited finances
• Uninsured
• Single or without social support
• Teen
• Domestic violence
• Drug/alcohol use
Proposed change:
A registered nurse meets privately for 4 one hour visits where the patient is encouraged to write goals and attend childbirth and breastfeeding classes. Participants are also offered incentives such as free books, maternity clothes, baby clothes, a breast pump, food vouchers, and a car seat.
Topics covered:
• Maternal/fetal growth and development
• Preterm labor
• Urinary tract infection prevention
• Nutrition
• Benefits of breastfeeding
• Seat belt use
• Smoking/second hand smoke
• Healthy relationships
• Sudden infant death prevention
• Shaken baby syndrome awareness
• Baby care/car seat usage
Implementation, outcomes and evaluation:
The Healthy Beginnings Program was established in 1996 and has enrolled between 100-172 patients annually. The annual operating budget for the Healthy Beginnings Program is approximately $35,000 per year. The average cost per participant in 2012 is $203. Statistics such as birth weight, length, number of neonatal intensive care days, gestational age, and hospital costs are compiled and compared to those not in the program, but who are similar demographically.
The comparative outcomes show that enrolled women tend to have babies that are slightly larger and slightly longer than nonparticipants who come from a similar client base. The most remarkable facts are the number of days spent in the neonatal intensive care unit and the gestational age. Year after year, program participants have healthier babies that are closer to term than nonparticipants. In 2009, the percentage of program participants that had babies at or below 37 weeks gestation was 8.8% compared to 15.2% of those who qualified for the program, but did not partake.
Implications for nursing practice:
Caring for the socially at risk pregnant family is an ongoing nursing challenge given the short hospitalization period at delivery. By establishing a rapport with families prenatally, the transition to home with a healthy mother and newborn is much easier and often times seamless saving both nursing time and energy.
Keywords: socially at risk, pregnacy education, health promotion program