Imparting Knowledge, Skill, and Confidence to Rural Nurses

Abstract

Poster Presentation Purpose for the Program The labor and delivery (L&D) nurse manager of a small community hospital contacted our academic medical center and requested assistance to train two medical/surgical nurses who float to the hospital's L&D unit for the occasional birth. Located in a remote area of Northern California with a low volume of births, the hospital setting is not conducive to providing adequate L&D experience for the nurses. A partnership was proposed to better prepare these nurses to care for L&D patients. Proposed Change Information provided by the community hospital indicated an extreme lack of resources for nurses who needed training in specialty areas. As a facility with less than 100 births per year located hours from the nearest city or major medical center, the hospital was not equipped to keep nurses current in L&D skills, knowledge, and practice. We were requested to provide a training opportunity incorporating 240 hours of didactic and practical instruction. Implementation, Outcomes, and Evaluation A contract was secured, and a training outline was developed and submitted for approval. Per UC Davis Medical Center (UCDMC) requirements, a day of hospital orientation preceded the nurses' L&D training. This included mandatory safety training and the signing of a confidentiality agreement. When the nurses arrived on L&D, the Association of Women's Health, Obstetric and Neonatal Nurses' (AWHONN) Perinatal Orientation and Education Program (POEP) testing was utilized as a baseline assessment of knowledge. Each nurse was assigned a master's‐prepared preceptor. The nurses received reference binders containing publications on fetal monitoring, labor and birth, postpartum care, newborn assessment, high‐risk obstetrics, obstetric emergencies, and operating room procedures, as well as journal articles. They attended lectures given by the perinatal nurse educator incorporating the POEP material. An AWHONN's Intermediate Fetal Monitoring Course (IFMC) was scheduled and conducted. Upon completion of the program, the nurses expressed tremendous gratitude to the staff and reported feeling much better prepared to care for perinatal patients. Scores on the POEP posttests increased by 32% and 44%, respectively, with an overall average score of 98.5% at the conclusion of the training. Implications for Nursing Practice The collaboration of hospitals from two very different milieus resulted in an unprecedented training opportunity for nurses caring infrequently for perinatal patients. The nurses reported an overwhelmingly positive experience. Other academic medical centers may consider developing similar programs to assist smaller hospitals in isolated areas with a lack of resources for nurse specialty training.