BACKGROUND: Placenta accreta spectrum disorder is a condition that is rare but is becoming more common due to the increase in cesarean rates. Placenta accreta spectrum disorder is known to have high morbidity and mortali...BACKGROUND: Placenta accreta spectrum disorder is a condition that is rare but is becoming more common due to the increase in cesarean rates. Placenta accreta spectrum disorder is known to have high morbidity and mortality rates due to its increased risk of hemorrhage. These surgical cases are complex and need to have a robust multidisciplinary team to decrease the risk of potential complications. Due to the complexity of this diagnosis, the plan of care must involve coordination of several specialties and roles as well as ensuring the patient has adequate education and explanation regarding the plan of care. METHODS: A placenta accreta spectrum disorder navigator was implemented to ensure optimal communication, equipment and team readiness, and a standardized approach to planning for patients with this diagnosis. An anonymous survey was sent to team members following placenta accreta spectrum disorder cases to evaluate their experiences, comparing results from before and after the implementation of the nurse navigator role. RESULTS: The survey included responses from 11 team members in pre implementation and 21 post implementations. Post-implementation data showed improvements in communication, role clarity, and teamwork. CONCLUSIONS: Reviewing pre- and post-survey data, along with feedback from discussions and debriefs, revealed that implementing a placenta accreta spectrum disorder navigator improved communication and team efficiency. Data showed enhancements in provider experiences and a reduction in action items from debriefs.
PURPOSE: Failure to rescue is the inability to prevent death by timely diagnosis and treatment of a complication. Nurses have a duty to surveil, identify crisis indicators, and take action when necessary. A gap exists in...PURPOSE: Failure to rescue is the inability to prevent death by timely diagnosis and treatment of a complication. Nurses have a duty to surveil, identify crisis indicators, and take action when necessary. A gap exists in resuscitation literature about mother-baby nurses' experiences identifying neonatal or sudden unexpected postnatal collapse (SUPC) and taking action once discovered, two components of rescue that are critical to quality care. To address the gap, this study investigated mother-baby nurses' experiences identifying and taking action during SUPC. STUDY DESIGN AND METHODS: For this qualitative descriptive study, mother-baby nurses from three hospitals in Colorado who experienced SUPC participated in semi-structured individual interviews. RESULTS: Six mother-baby nurses were interviewed in 2021 or 2022. They ranged in age from 29 to 48 years and had between 5 and 25 years of experience. Five of the nurses had completed the Neonatal Resuscitation Program course. Qualitative content analysis revealed two themes. The Assumption of Well represents factors related to identifying SUPC: Family Bonding, Mother-Baby Unit Environment, Teamwork, and Nursing Practice. The Balancing Act of Mother-Baby Nursing highlights those related to taking action: Physical Environment, Patient Experience/Satisfaction, Interdepartmental Culture, and A Low Volume Event. CLINICAL IMPLICATIONS: Mother-baby nurses, who navigate many challenges as they identify and react to SUPC, should be cognizant of its potential influencing factors. Suggestions for organizations such as increased nurse education, parent education, and nurse staffing based on national standards are provided to optimize nurses' ability to identify and treat SUPC.
Burke LT, Noori E, Pham C
… +3 more, Heng V, Lucas CT, Guo Y
MCN Am J Matern Child Nurs
· 2025 Sep-Oct 01 · PMID 40797136
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INTRODUCTION: Doulas are skilled paraprofessionals who provide supportive care to pregnant women and birthing people resulting in improved outcomes. However, conflicts persist between health care providers and doulas in...INTRODUCTION: Doulas are skilled paraprofessionals who provide supportive care to pregnant women and birthing people resulting in improved outcomes. However, conflicts persist between health care providers and doulas in hospital-based maternity care teams. Few studies have addressed this phenomenon from the doulas' perspective, particularly doulas from racial and ethnic minority backgrounds. METHODS: This qualitative study used individual semi-structured interviews to explore the experiences and perspectives of perinatal doulas caring for pregnant women from various backgrounds. Transcriptions were analyzed. RESULTS: Seven doulas participated, five of whom self-identified as Black or African American. Three themes were identified: Barriers to Including Doulas in Team-Based Care, Facilitators to Improving Interdisciplinary Collaboration, and Educational Needs and Support. Doulas emphasized the need for mentorship and support for novices transitioning to hospital settings, particularly when caring for high-risk patients. CONCLUSIONS: Doulas are integral in advocating for pregnant women from diverse backgrounds and helping them to navigate complex health care systems. Given the inequities affecting Black and African American maternity patients, incorporating racial minority doulas in team-based care is critical. Career development and mentorship can help novice doulas integrate smoothly into hospital environments.
INTRODUCTION: Perinatal mood and anxiety disorders can have lasting negative impacts on maternal and child health. The aim of the quality improvement project was to determine if home-based psychosocial interventions for...INTRODUCTION: Perinatal mood and anxiety disorders can have lasting negative impacts on maternal and child health. The aim of the quality improvement project was to determine if home-based psychosocial interventions for perinatal mood and anxiety disorders using volunteers affect patient outcomes and expand evidence-based treatment options. METHODS: We used a logic model to outline the program's key inputs and outputs, and to guide ongoing implementation; outline what did or did not occur as intended in the volunteer program; clarify for organization stakeholders how program activities bring about desired changes or outputs; and to determine if the program brings about desired outcomes in relation to perinatal mental health. The major outcomes of interest were pre and post measures of perinatal mood and anxiety disorders symptoms, stress, and level of reported support in the parents. RESULTS: Data were obtained from two subsamples, 152 parents prior to receiving the intervention and from 36 parents after receiving the intervention. Before receiving the services, 33.0% of the parents endorsed clinically significant symptoms of anxiety and depression. At the end of the intervention, 66.7% of parents reported experiencing symptoms of perinatal mood and anxiety disorders, and 75.0% of those experiencing symptoms agreed the support from the program helped alleviate those symptoms. DISCUSSION: Our results highlight the program as an effective and accessible option to mitigate perinatal mood and anxiety disorders in the community. There is need for more effective, evidence-based interventions in the community setting.
PURPOSE: Describe the implementation of trauma-informed care education and the attitudes toward trauma-informed care among birth workers in Maryland. STUDY DESIGN AND METHODS: Cross-sectional descriptive study of health...PURPOSE: Describe the implementation of trauma-informed care education and the attitudes toward trauma-informed care among birth workers in Maryland. STUDY DESIGN AND METHODS: Cross-sectional descriptive study of health care professionals involved in the childbirth continuum of care in Maryland. Data collection was conducted between January 11th and February 23rd, 2024 as a pre-survey to a grant-sponsored trauma-informed care education program. The Attitudes Related to Trauma-Informed Care (ARTIC) scale was used to quantify participants' trauma-informed care attitudes. RESULTS: There were 220 participants in the educational sessions, 111 of whom met inclusion criteria and participated in the survey. The ARTIC scale had a mean of 5.38 (SD 0.7) across all participants, scores ranged from 2.16 to 6.51, indicating receptive birth worker attitudes toward trauma-informed care. Lowest sub-scale scores were for understanding the underlying causes of trauma and identifying adequate system support for trauma-informed care. There were significant differences in ARTIC scores between nurse participants (M 5.34, SD = 0.51) and those in other roles (M 5.6, SD = 0.58), with nurses exhibiting lower scores (p = .035). CLINICAL IMPLICATIONS: Maryland perinatal professionals are receptive to trauma-informed care practices and would benefit from targeted education to more fully understand the underlying causes of trauma and initiation of a universal approach to trauma-informed care. Health care leaders should demonstrate their commitment to trauma-informed care by providing team members who care for women during childbirth with increased resources, education, and support for this care model.