Best Practices for Transitioning from the Birthing Unit to the Mother–Infant Unit

Abstract

Poster Presentation Purpose for the Program As we sought to obtain Baby Friendly Hospital designation, we had the opportunity to evaluate our practices in transitioning women from the birthing unit to the mother/infant unit. We discovered two critical practices that were suboptimal and lacked supporting evidence for best patient outcomes: nurse‐to‐nurse hand‐off and the mother/infant admission process. To improve patient outcomes and satisfaction, our team recognized that these two practices were interdependent and required a synergistic problem solving approach for change. Proposed Change The traditional practice of telephone hand‐off was time consuming, inefficient for nurses with multiple demands, did not engage the woman and family, and was not conducive to a seamless transition from one unit to another. Importantly, this transition process, which routinely separated well newborns from healthy postpartum mothers for admission care, had the potential to interfere with bonding and breastfeeding success. An interprofessional team led by the councils of the birthing and mother/infant units recognized the relationship between these processes and the need to align them with Baby Friendly and family‐centered care practices. They developed, implemented, and evaluated an evidence‐based practice project that transitioned the mother/infant dyad from the birthing unit to the postpartum room for admission care while integrating face‐to‐face interprofessional bedside hand‐off. Implementation, Outcomes, and Evaluation The councils were instrumental in identifying, developing, and evaluating these practice changes. Before piloting, women and nurses were surveyed regarding the current processes and then again after implementation. During the pilot period, more than 130 mother/infant dyads were transitioned directly to the postpartum room for admission care with no adverse outcomes related to the process. In addition, unit council representatives also collaborated with provider stakeholders to develop and pilot the interprofessional face‐to‐face bedside hand‐off process. They developed a notification strategy and utilized technology to provide consistent information among team members. Since full implementation of these practices, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores have shown significant improvement as well as breastfeeding initiation and rooming in rates. Implications for Nursing Practice The benefit of a seamless transition process that allows mothers and newborns to stay together from birth until discharge is well documented. Nurses have a responsibility to examine current practices, move away from nurse‐centric traditions, and initiate those that move toward evidence‐based, patient‐centric best practices.