An In-house Program of Continuing Education for Perinatal Nurses

A learning program implemented with motivation and peer-group teaching was combined with a program of learning through research on a topic and sharing this information with others. In using these two methods of learning, both inexperienced and highly skilled perinatal nurses have been able to continue effectively their education, using resources in their own institution.     

Evaluating the Effectiveness of a Perinatal Outreach Education Program

Quality care for high-risk mothers and neonates is achieved only after quality perinatal care on all levels can be realized. In order to attain this goal in southern Illinois, a perinatal outreach education program was designed for health professionals within the region. An evaluation provided documentation of changes in perinatal care at the community hospital level.     

Intrauterine Contraception: Knowledge and Prescribing Practices of Canadian Health Care Providers

ObjectiveContraception is an important issue in the lives of women, their partners, and society. Canadians and their health care providers play a critical role in contraceptive decision making that influences individuals and Canadian society. The purpose of this study was to gather data on contraception-related knowledge, counselling, and prescribing practices of Canadian health care providers.MethodsThis project reported on the outcomes of an educational initiative, designed as a quality improvement initiative (time series level II-3), focused on Canadian health care providers’ contraception-related knowledge, counselling, and prescribing practices. Outcomes were intended to inform the development of tools, resources, and educational programming. Part 1 was an online program to identify educational and knowledge gaps for health care providers. Part 2 was a practice assessment exploring and measuring health care providers’ contraceptive counselling and prescribing practices.ResultsA total of 4300 health care providers completed the program between July 6, 2015 and August 30, 2016. Knowledge significantly increased; post-test scores were higher than pretest scores. After completion, all participants felt more comfortable, knowledgeable, and inclined to change their practice around prescribing intrauterine contraception (IUC). The 4300 providers reported on their contraception counselling experiences with 10 patients following participation in Part 1. Forty percent of patients were using oral contraceptives, and 53% were dissatisfied with their current type of contraception. After counselling, patients reported being most comfortable with IUC (55%). Both short- and long-acting types of contraception were most often discussed or offered (74% of the time), followed by long-acting reversible contraception only (21%) and short-acting methods only (5%).ConclusionThis training program filled an education need for patients and gave providers tools to change their behaviour and practice around IUC prescribing. On the basis of these data, a practice assessment model was deemed a successful way to change behaviour.     

Effects of Climate Change and Air Pollution on Perinatal Health

Climate change is often framed as an environmental concern; however, the burning of fossil fuels both directly and indirectly impacts air quality and, thus, human health. Gas byproducts of combustion lead to increased levels of atmospheric ozone and carbon dioxide, which in turn elevate surface temperatures of the earth. This process exposes individuals to respiratory irritants and contributes to increased frequency of natural disasters such as wildfires, negatively impacting respiratory health. Normal physiologic changes in the respiratory system make pregnant people particularly vulnerable to the effects of air pollution. Asthma and allergic rhinitis are 2 common respiratory diseases that can be triggered by poor air quality. Solutions to limit the impact of climate change on respiratory disease include risk mitigation and reduction of fossil fuel consumption on individual, organization, and community levels. Midwives are well positioned as clinicians to educate people about individual strategies to reduce environmental exposure to respiratory irritants and advocate for policy changes to limit future health effects of climate change.     

Outcomes of the Introduction of the MOREOB Continuing Education Program in Alberta

ObjectiveIn 2004, the three-module, three-year long patient safety program, Managing Obstetrical Risk Efficiently (MORE^OB), was introduced to all clinicians providing obstetrical services in Alberta. We report on an outcomes evaluation of this initiative.MethodsProvincial hospital discharge abstracts for each mother and infant were obtained from 2003 through 2008. A pre–post design with a multivariate analysis was conducted for each relevant maternal and fetal outcome.ResultsFor maternal outcomes, third- and fourth-degree tears and length of stay were significantly decreased. For newborn outcomes, severe morbidity was significantly reduced.ConclusionThe MORE^OB program was associated with improvement in selected maternal and fetal health outcome indicators. When a patient safety program is introduced as an intensive, long-term continuing education and quality improvement initiative, health outcomes can be significantly impacted.     

Low Levels of Knowledge and Preventive Practices Regarding Vertical Hepatitis B Transmission among Perinatal Nurses

ObjectiveTo evaluate current levels of hepatitis‐B‐related knowledge and clinical practice among perinatal nurses.DesignCross‐sectional study.SettingSanta Clara County, California, home to one of the largest U.S. populations at risk of perinatal hepatitis B transmission.ParticipantsPerinatal nurses (N = 518) from eight birthing hospitals.MethodsIn 2008–2010, nurses completed a baseline survey evaluating existing hepatitis‐B‐related knowledge and preventive clinical practices, participated in an educational seminar, received instructional materials about hepatitis B, and completed a follow‐up knowledge survey.ResultsEighty percent of perinatal nurses had provided health care to a pregnant woman with chronic hepatitis B, but only 51% routinely provided patients with educational information about hepatitis B. While 75% routinely informed patients about effective methods to prevent mother‐to‐child transmission, only a small minority (17–34%) educated infected women about standard recommendations for protecting themselves and household members. One fourth or fewer nurses correctly answered most questions about hepatitis B prevalence, risks, and symptoms. After the educational seminar, knowledge increased statistically significantly.ConclusionExisting knowledge about hepatitis B is limited, and nationally recommended preventive clinical practices are commonly overlooked by perinatal nurses. This lack of knowledge and preventive care represents a noteworthy gap and an opportunity for targeted training and education to improve perinatal hepatitis B prevention and medical management of infected mothers.     

A Perinatal Education Consortium: Improved Resource Utilization

Maternal Newborn Nurse Professionals of Southeastern Michigan is an organization of nurses from more than 30 hospitals. The organization formed a committee to provide a comprehensive, cost-effective educational program for new nurses or nurses who were being cross trained, which would improve resource utilization in the region. Twice a year the organization offers a 5-day educational program covering antepartum, fetal monitoring, intrapartum, postpartum, and neonatal issues. The development, implementation, and evaluation of the program are outlined.     

Success of a Lactation Education Program on NICU Nurses' Knowledge and Attitudes

Objectives: To test an educational intervention designed to improve lactation knowledge, attitudes, and beliefs of NICU nurses and to improve their intentions to provide mothers with lactation support.
Design: Quasi-experimental, time-series pretest/posttest.
Setting: NICU of a Midwestern, free-standing, tertiary-care children's hospital.
Participants: Convenience sample of 64 NICU nurses and 2 separate convenience samples of mothers of infants hospitalized in the NICU ( n =19 and 13, respectively).
Methods: Nurses were measured on study outcomes at multiple time points, beginning with 2 weeks before and ending at 3 months after attendance to a 4-hour educational program. Mothers were sampled before and 3 months after the intervention.
Main Outcome Measure(s): Nurses' lactation knowledge, attitudes, beliefs, and intentions to support lactation and mothers' perceptions of lactation support in the NICU.
Results: Findings suggest that this educational intervention was effective for improving NICU nurses' lactation knowledge and attitudes, and that these improvements were maintained over time. Further, the supportive atmosphere for lactation in this NICU significantly improved following the implementation of the educational intervention for nurses.
Conclusion: Intermittent, short educational programs which include practical how-to's and motivational encouragement for staff may provide the empowerment nurses need in order to be supportive of lactation.     

Beliefs About Breastfeeding: A Statewide Survey of Health Professionals

ABSTRACT: A statewide project was implemented in 1993 to increase breastfeeding among low-income women in North Carolina through improved institutional policies and practices and professional lactation-management skills. A survey designed to ascertain professional beliefs about breastfeeding was mailed to 31 hospitals and 25 public health agencies. A total of 2209 health professionals completed the survey and met the study selection criteria. Nutritionists and pediatricians were most likely to have positive beliefs about breastfeeding, whereas hospital nurses were most likely to have negative beliefs. Personal breastfeeding experience contributed to positive beliefs. Professionals were least convinced of the emotional benefits of breastfeeding. Those with negative beliefs were most likely to advocate complete infant weaning from the breast before nine months of age. Although most health professionals had positive beliefs about breastfeeding, differences by profession, work environment, and personal breastfeeding experience indicate the need for comprehensive training in lactation management, and improvements in hospital and public health clinic environments.     

A Birth Education Program for Expectant Fathers in Taiwan: Effects on Their Anxiety

Background: A father who does not know how to assist the mother in relieving labor pains may experience a sense of powerlessness and anxiety. The objective of this study was to evaluate how an education program for expectant fathers who attended their partners' labor and birth affected their anxiety. Methods: In a randomized controlled trial, 87 expectant fathers who attended their pregnant partners through labor and birth at a hospital in central Taiwan were allocated by block randomization to an experimental (n = 45) and a control (n = 42) group. The men completed their basic personal information, a childbirth expectations questionnaire, and a Trait Anxiety Inventory when they were recruited. Two hours after birth of their child, all the expectant fathers completed a State of Anxiety Inventory. Results: Our results showed no statistically significant differences between the experimental and control groups of fathers in trait anxiety and their prenatal childbirth expectations. After analysis of covariance (ANCOVA) was applied to correct for education level, sources of childbirth information, attendance at Lamaze childbirth classes, and childbirth expectations at baseline, the effect of the childbirth program was significant for the postnatal level of anxiety (F = 3.38, p = 0.001). Conclusions: The study findings justify the clinical implementation of a birth education program based on the self‐efficacy theory as an effective means of reducing anxiety among expectant fathers.