An Innovative Approach to Addressing Anemia in the Perinatal Patient
Title: An Innovative Approach to Addressing Anemia in the Perinatal Patient
- Identify two causes of prenatal anemia.
- Review selected non-pharmacological interventions for the treatment of prenatal anemia, including enhanced collaboration and communication amongst health care providers.
- Identify the elements for the successful implementation of an innovative program to treat prenatal anemia.
Pregnancy related anemia is a common occurrence in today’s health care environment. Many factors come into play such as less than optimum nutritional intake, everyday demands on women and self care deficits. These factors are magnified in the urban setting where limited fiscal and human resources exist. Managing patient care through the continuum, from the prenatal period through the post-partum period, is essential to insure optimum patient outcomes and efficient use of the limited resources available.
Proposed change:
Changing the process by which patients with prenatal anemia were managed was essential to improved outcomes and decreases the use of resources during the post-partum period. This urban hospital developed a process in which patients with downward trending hemoglobin (< 8.0) were provided early interventions to avoid the use of blood transfusions and pharmaceuticals during the post-partum period. The interdisciplinary approach of physicians, nurses, program coordinator along with the patients was established to better prepare the patient for delivery.
Implementation, outcomes and evaluation:
The first step was to establish guidelines for Bloodless Medicine and Surgery Program (BMSP) consults while not over-burdening current resources. Patients presenting with anemia had a BSMP consult. The consult consists of nutritional counseling, recommendations for treatment and supportive counseling. Guidelines were adjusted and communication processes between the health center and the BMSP coordinator were modified as needed.
The BMSP plan of care documentation changed from manual to electronic documentation which allowed all team members to access. The role of the health center nurses changed to a more active participant in the assessment of their anemia through their intake at each visit. A decrease in post-partum BMSP consults on the post-partum unit was noted after initiation of the program, indicating improved identification in the prenatal period.
Implications for nursing practice:
Early intervention with prenatal anemia allows the clinician to intervene when the client is more amenable to learning and following treatment regimes which impact the client beyond the perinatal period. Continued innovations such as these provide evidence that innovative programs initiated by nurses can impact the health of individuals and communities as well as impacting healthcare changes overall.
Keywords: prenatal anemia, urban setting, managing care