do not disturb…moms and babies resting! a successful implementation of quiet hours on a postpartum...

The Multidisciplinary Approach to Maternal

Health Care

Poster Presentation

Purpose for the Program

Toaddress the mother’s physical, emotional, so-

cial, and spiritual needs. The multidisciplinary

team meets each week to develop an approach to

maternal care with the goal of decreasing preterm

births and increasing maternal satisfaction during

prolonged hospital stay. We have developed a multi-

disciplinary team that focuses on and treats the

obstetric (OB) patient with a holistic health approach.

Proposed Change

To improve patient satisfaction and prolong preg-

nancy by identifying and meeting the needs of the

hospitalized mother utilizing a holistic approach.

Implementation, Outcomes, and Evaluation

The multidisciplinary team and the charge nurse

meet on a weekly basis to identify patients who

may need the resources o¡ered by the team then

developacare plan that is patient speci¢c.They solicit

the mother’s participation and make her an integral

part of the planning and implementation of the care

plan. As a result, mothers are more compliant with

recommendations for hospitalization and report

greater satisfaction with hospital care, and pregnancy

is prolonged. Shorter stays in the neonatal intensive

care unit for the infant are a result of prolonged preg-

nancy. The team monitors the mother’s utilization of

the resources available and compliance with treat-

ment recommendations and follows up by

incorporating patient rounding, reassessing, and re-

developing the care plan to ¢t identi¢ed needs.

Implications for Nursing Practice

Provide a process that will improve patient satisfac-

tion that can in£uence and perhaps avoid preterm

birth of an infant. Serve as a resource for obtaining

alternative methods of meeting the patient’s needs

using a holistic approach.

Do Not Disturb...Moms and Babies Resting! A

Successful Implementation of Quiet Hours on

a Postpartum Floor

Poster Presentation


To increase patient satisfaction, increase breast-

feeding success, and decrease extreme fatigue.

Postpartum is a time in a women’s life with many new

challenges, changes, and choices. There is often

much excitement that surrounds the birth of a new

family. Many times that excitement may turn to frustra-

tion, exhaustion, and a lack of con¢dence for the new

mother.

There are many interruptions to new mothers

day and night with nurses, visitors, demand feed-

ings, pain, other hospital sta¡, and telephone

calls. In 2006 Morrison and colleagues found

that new moms struggled through many of these

interruptions during their days. This study focused

on breastfeeding interruptions and the decrease in

the incidence of breastfeeding success. In addition,

extreme fatigue has been observed to be a contrib-

utor to the occurrence of postpartum depression.

Marginalized sleep periods and frequent interrup-

tions by infant and sta¡ contribute to insu⁄cient

sleep or rest periods. In addition, patient satisfac-

tion surveys conducted by an independent

organization con¢rmed our suspicions regarding

patients’ experiences on our maternity unit.

Proposed Change

Designated quiet hours. Through the review of evi-

dence on sleep deprivation and its consequences

as well as literature reviews on interruption and its

e¡ect on breastfeeding, our Perinatal Unit Practice

Council organized a task force to address these is-

sues and prepare an improvement proposal. This

proposal led to the initiation of quiet hours for a pe-

riod of 2 hours on our £oor.

Sherri Thomas, RN-BSN,

RNC, Antepartum Unit, Bay-

lor University Medical Center

of Dallas, Dallas, TX

Keywordsholistic approachprolonged hospital staypatient satisfaction

Childbearing

Julie Vasher, MSN, RNC-OB,

CNS-BC, C-EFM, Labor &

Delivery, Salinas Valley

Memorial Healthcare System,

Salinas, CA

Norma Coyazo, RNC-OB,

Labor & Delivery, Salinas

Valley Memorial Healthcare

System, Salinas, CA

Keywordsquiet hoursuninterrupted rest

Childbearing

S14 JOGNN, 40, S2-S84; 2011. DOI: 10.1111/j.1552-6909.2011.01242.x http://jognn.awhonn.org

I N N O V A T I V E P R O G R A M S

Proceedings of the 2011 AWHONN Convention


This presentation will review the evidence and outline

the process for change, including support areas in the

hospital, sta¡ education, and implementation steps.

In addition, patient surveys will show an improvement

in satisfaction re£ected by qualitative interviews as

well as discharge surveys.


We also feel that by o¡ering quiet hours and provid-

ing patient education, we are modeling behaviors

that patients can use at home once they are dis-

charged. They can use a similar method to curb

visitors during periods of rest through the use of a

sign placed on their doors.

Increasing Awareness-Inspiring Hope: Postpartum

Emotional Support Program

Poster Presentation


This poster describes the implementation of

a Postpartum Emotional Support Program

(PESP) for all postpartum patients who deliver at

our center.The goal of our program is to identify, ed-

ucate, and provide support to those new mothers

who may be at risk for developing postpartum de-

pression. Our program enables all women who give

birth at The Women’s Center at University Commu-

nity Hospital to complete a voluntary postpartum

depression risk assessment questionnaire and to

have the answers scored by one of the PESP spe-

cialists. Based upon their scores they are seen by

one of our PESP specialists who reviews the ques-

tionnaire with the patients and identi¢es nursing

interventions and appropriate follow-up.

Proposed Change

To increase the awareness of signs and symptoms

of postpartum depression in our postpartum popu-

lation and our community.


Data are collected on all mothers who give birth at

TheWomen’s Center via the postpartum depression

risk assessment tool within 12 to 24 hours of deliv-

ery. For those who score at risk for postpartum

depression, health outcomes will be measured by

the PESP registered nurse. The outcomes that we

hope to achieve through the implementation of our

program are the early detection of postpartum

depression with the appropriate support and fol-

low-up care for these patients and increasing

community awareness. Our program started in mid

April 2009. Statistics are as follows: April 2009

through December 2009 1,354 patients were

screened; 20.9% were identi¢ed with signi¢cant

risk factors. January 2010 through July 2010 1,234

patients were screened; 21.6% were identi¢ed with

signi¢cant risk factors.


To heighten the standards of nursing care for pa-

tients and families through education and resource

information.

DRAWING the LINE at 39 (WEEKS): A

System-Wide Approach to Reducing Elective Births

Before 39 Weeks Gestation

Paper Presentation


Research has shown that iatrogenic prematurity

can often be the result of deliveries before 39

completed weeks gestation. The primary goal of this

program was to reduce the incidence of elective

births at less than 39 week gestation across Centura

Health. This has been a long-held national standard

set forth by the American College of Obstetricians

and Gynecologists but one that was often ignored.

Proposed Change

Standardized policy (across a nine hospital system)

requiring a maternal or fetal medical indication to

June Vinyard, RN, BSN,

Mother-Baby & Gynecology,

University Community Hospi-

tal, The Women’s Center,

Tampa, FL

Keywordspostpartum depressionidentifying risk factor for

postpartum depression

Childbearing

Candace Garko, CNS, MSN,

RNC-OB, C-EFM, Birth Cen-

ter, Centura Health, St. Francis

Medical Center, Colorado

Springs, CO

JOGNN 2011; Vol. 40, Supplement 1 S15

Vinyard, J. I N N O V A T I V E P R O G R A M S

Proceedings of the 2011 AWHONN Convention

do not disturb…moms and babies resting! a successful implementation of quiet hours on a postpartum...

Documents