Multidisciplinary Antepartum Model of Care to Improve Perinatal Outcomes

Abstract

<h2>Professional Issues Poster Presentation</h2><h3>Purpose for the Program</h3> The Maternal–Child Health Services Multidisciplinary Antepartum Team Project was developed to identify evidence‐based practice and guide nursing care with a model of approach that involves all disciplines of care, plus the patient and her family. The goal of the multidisciplinary antepartum team is to use all members of the healthcare team, to address needs of the patient, to potentially lengthen pregnancy, improve fetal well‐being, decrease maternal adverse events, and reduce the need to admit infants to the neonatal intensive care unit. <h3>Proposed Change</h3> To improve maternal/fetal outcomes through early identification and communication of maternal risk factors by developing a multidisciplinary individualized plan of care. This team will use evidenced‐based nursing research to improve patient outcomes, decrease the emotional and physical stressors of a long‐term hospitalization, and to positively affect the patient's perception of the healthcare team. <h3>Implementation, Outcomes, and Evaluation</h3> The Maternal–Child Healthcare team identified the need for improved communication and collaboration for long‐term hospitalized antepartum patients. A multidisciplinary team that included members from education, nursing, social services, research, and management convened to examine the need to improve antepartum care. As a result of the initial team planning, new nursing processes have been implemented. Specific changes include a daily huddle to discuss patient diagnoses, diagnostics, consultations, plan of care for the day, and the use of the antepartum SBAR tool to improve communication. The primary nurse reviews the daily plan of care with the team and the patient, and also solicits information from the patient to identify urgent needs, with specific attention to emotional and physical well‐being. A weekly meeting that includes the patient's obstetrician, perinatologist, neonatologist, nursing team, social services, pastoral care, and unit educators is planned to continue the collaborative care model to achieve the best possible outcome for the patient and the infant. <h3>Implications for Nursing Practice</h3> The patient's status is reviewed and evaluated daily by the nursing team at the daily huddle. The goals for the previous plan of care are reviewed, to be certain that goals were met or refined. Patient provides information to the nursing team daily to identify any needs that have yet to be addressed or resolved. The multidisciplinary team continues to meet, update, and communicate goals for the patient, until the patient gives birth or is discharged.