Date of Conferral
Doctor of Nursing Practice (DNP)
Dr. Barbara Niedz
Communication is vital to improve patient care outcomes, especially with high acuity patients. Pregnant patients differ from other patient populations because their care involves 2 entities: the patient (mother-to-be) and her unborn fetus. There has been a noted gap in communication and care collaboration between the emergency department (ED) and obstetric (OB) teams at the project site, resulting in delays for patients and lack of appropriate maternal/fetal assessment and contributing negatively to patients' experiences. Using transitions theory and the Rosswurm and Larrabee model, a clinical practice guideline (CPG) inclusive of an obstetrically focused algorithm was developed and presented for use as a communication and care collaboration tool. The implications of this project for nursing practice and positive social change include improved communication and care collaboration at an interdepartmental level when this high acuity patient population presents to the ED for care. The CPG was presented at 3 discussion sessions with 51 administrators, managers, educators, and/or charge nurses from the ED and OB departments of the project site. Overall, nurses reacted positively to the practice guideline and barriers were identified. A qualitative descriptive design was used for this project. Examples of codes identified included 'only 1 portable fetal monitor' and 'new ED nurses don't know whom to call.' From the codes, 3 categories surfaced: (a) education, (b) prioritization, and (c) equipment; and 1 theme emerged: preimplementation needs. The potential impact on pregnant patients who present to the ED after this CPG is fully implemented might be to reduce delays in the ED, ensure patient safety, and improve patients' experiences.