How Do You Support Early Pregnancy Losses? the Miscarriage Management Training Initiative: Improving Care for Women
Title: How Do You Support Early Pregnancy Losses? the Miscarriage Management Training Initiative: Improving Care for Women
- Describe 3 miscarriage management options safely managed in outpatient setting.
- Identify 3 ways that patient-centered miscarriage management is central to the nursing model of care.
- Name 2 significant findings from the MMTI experience in Washington.
Proposed change:
Training registered, advance practice nurses and allied health care staff to provide comprehensive care for EPL in an office-base setting has the potential to reduce costs, provide evidence-based and community standard services and to expand access, especially for underserved women. It also has the potential to address the myriad of emotions women experience by modeling patient-centered care.
Implementation, outcomes and evaluation:
The MM-TI was first implemented with physicians, nurses and allied health care staff in family medicine residency programs in Washington State. Our primary outcome was self-reported practice of MVA following the training. The evaluation demonstrated a significant program effect (pre/post intent to practice MVA, controlling for individual and site-level confounders). Also shown was a significant effect of clinical and administrative support staff knowledge of MVA on physician intent to practice MVA.
The MM-TI has now expanded to other states and broadened the scope to include OB/GYN physicians, nurse managers, nurse-midwives, nurse practitioners and allied health care staff. Our preliminary qualitative assessment with stakeholders in Washington State pointed to the importance of clarifying scope of practice (SOP) for miscarriage management and for MVA usage in particular.
Implications for nursing practice:
Nurses play key roles in caring for women experiencing miscarriage (EPL). Roles include providing direct services for EPL, education, counseling, systems management, training staff, assisting the provider and providing patient-centered care.
Keywords: Miscarriage management, spontaneous abortion, early pregnancy loss, patient-centered care