| Abstract: | The Perinatal Continuing Education Program consists of a nine-month intervention with community hospital nurses, physicians, and support personnel. Components include a hospital self-inventory of resources, coordination by community hospital staff, a skills workshop, and self-instructional books. This article outlines a follow-up strategy to the basic program and describes changes in community hospital knowledge and care practices that occur between programs. The follow-up program presented includes a modified coordinators' workshop, identification of updated self-instructional materials for careful study by past participants, and a self-survey of "recommended routines" intended to facilitate change in hospital policies. Otherwise, except for the deletion of the resources inventory, the follow-up program is similar to the basic program. Testing of participants and detailed review of 1435 hospital charts at sequential time periods revealed a decline in mean knowledge scores between programs, higher scores by new participants before follow-up when compared to pre-basic program, a plateau of patient care quality between programs, and a further improvement in patient care quality after the follow-up program. We conclude that a follow-up program is best accepted after three years but that timing is not critical. Evaluation measures suggest that new knowledge and care practices become institutionalized as a result of this program and that altered care practices are not simply a result of improved performance by individuals. |
