Improving Care of Women Experiencing a Pregnancy

The purpose of the Doctor of Nursing Practice (DNP) project was to provide evidence-based staff education at a pregnancy resource center to increase staff/patient engagement and communication by implementing a clinical practice change and use of a DNP student-developed discharge summary referral form (DRF) to assist with assessing patient’s needs, evaluating access to services and utilization of medical care and health promotion services. The overall aim of this project is to increase care with medical follow-up and seek to address improving engagement and communication with patients during their care and after discharge from the Pregnancy Resource Center (PRC). The major objectives of the project were to evaluate if the implementation of a DRF improved pregnant women’s access to or utilization of medical care services or resources, and to identify barriers to patients’ utilization of medical care services. Kolb’s Model guided the quality improvement project that utilized pre-intervention surveys in comparison to post-intervention survey results in addition to discharge follow-up data from the Pregnancy Resource Center to evaluate the referral process before and after the implementation of a DNP student-developed DRF following staff post educational training. The discharge referral form is divided into four sections: 1) demographics & recommended time frame for follow-up after discharge, 2) recommendations of follow-up care based on preliminary findings, 3) medical follow-up care outcome, and 4) discharge summary follow-up & well-check call. The DNP student observed for any difference in pregnant women’s medical care follow-up and access to/utilization of medical care services after a clinical practice change with staff education and implementing the discharge form. Additionally, the DNP student evaluated potential causes of pregnant patients not utilizing medical care services. Data analysis showed that there was a statistical difference of a change of 1.43 and 47.3 percent in staff engagement and communication concerning follow-up after staff engagement and communication educational training and the implementation of a DNP student-developed patient referral form. The project’s data revealed the primary reason pregnant women are not utilizing medical care services is due to financial barriers ranging from unemployment to an absence of insurance, undecided about pregnancy progression, and adversities in the organization, practices, and atmosphere of prenatal/postnatal services themselves. The initial assumption of the DNP student was that repeat pregnancy and underutilization of medical care services were not readily accessible to the pregnant population. However, the results of the quality improvement project refuted this assumption as medical care services were found to be available to women experiencing unplanned pregnancies. However, the services were often not utilized due to a lack of insurance and a breakdown in communication and the referral process. The use of evidence-based approaches can improve discharge, coordination, and transition for the continuation of care. Doctor of Nursing Practice (DNPs) can address challenges to healthcare access and utilization of available resources by supporting pregnant patients’ navigation through the complex healthcare system