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©2009 AWHONN Prematurity Prevention Action Steps and Future Directions Role of the Clinical Role of the Clinical Community Community Kim Armour, NP-BC, APN, MSN, RDMS 2009 AWHONN President
©2009 AWHONN
Prematurity PreventionAction Steps and Future
Directions
Role of the Clinical Role of the Clinical CommunityCommunity
Kim Armour, NP-BC, APN, MSN, RDMS
2009 AWHONN President
©2009 AWHONN
DisclosureDisclosure
I disclose that I have received a stipend as IHI Expert Faculty for Perinatal IMPACT team projects
No pharmaceuticals or medical devices are discussed in this presentation.
©2009 AWHONN
Late Preterm Infant Late Preterm Infant InitiativeInitiative
©2009 AWHONN
Late Preterm Initiative Late Preterm Initiative GoalsGoals
Raise awareness of unique needs of late preterm infants
Emphasize need for research Encourage development and adoption of
evidence-based guidelines for late preterm care Provide resources for clinical assessment and
parent education Foster collaboration among other health care
provider stakeholders
©2009 AWHONN
AWHONN’s Late Preterm AWHONN’s Late Preterm Infant Conceptual Infant Conceptual
FrameworkFramework
Late Preterm Initiative Late Preterm Initiative ProgressProgress
Awareness Education Change in Practice
Late Preterm Infant Assessment Guide
Optimizing Health for Late Preterm Infants
Breastfeeding Support Evidence-Based Guidelines
Perinatal and Neonatal Orientation and Education Programs
©2009 AWHONN
Late Preterm Infant Late Preterm Infant Research Based Practice Research Based Practice
(RBP) Project(RBP) Project Need established by 2005-2006 Near-Term
(Late Preterm) Infant Advisory Panel
Overall purpose of RBP to develop an evidence-based clinical practice guideline (EBG), evaluate the effect of education and implementation of the EBG on nursing practice; and learn more about the late preterm infant.
Partnership with Johnson & Johnson Pediatric Institute
©2009 AWHONN
Late Preterm Infant Late Preterm Infant (LPI) RBP Project (LPI) RBP Project
OutcomesOutcomes Increase nurses’ knowledge
Integrate the Evidence Based Guideline into practice
Describe parent knowledge of risks associated with late preterm birth in each clinical site
Describe the LPI patient population & risks associated with late preterm birth
©2009 AWHONN
LPI-RBP ParticipantsLPI-RBP Participants
145 institutions applied 15 selected; 2 in Canada by meeting
several criteria A Site Coordinator (RN) identified at each
site to lead project Each site completes individual IRB Currently 12 sites IRB approved
©2009 AWHONN
RBP Project RBP Project Evidence-Based Guideline Evidence-Based Guideline
(EBG)(EBG) Science team of experts created to review
and score literature; and develop the EBG
EBG created
EBG Quick Care Guide provided for easy reference
Implemented in LPI-RBP after educational components and before data collection
©2009 AWHONN
Methodology and Data Methodology and Data Collection Collection
Late Preterm Infant
Research-Based Project
Implementation
©2009 AWHONN
Pre-Implementation Pre-Implementation Data CollectionData Collection
Case-scenario-based integration test: Designed to evaluate integration of knowledge of LPI
care before formal education and guideline implementation
Narrative patient case scenarios accompanied by relevant questions
Pre-test Webinar Post-test: Designed to evaluate basic knowledge about LPI
issues and care before and after nurse education
©2009 AWHONN
Implementation Implementation
Following completion of pretest and webinar, staff will have access to the project evidence-based guideline (EBG) All participating staff must complete pre-
implementation work before EBG
Site Coordinator ensures staff are comfortable using the EBG
©2009 AWHONN
Implementation Implementation (Continued)(Continued)
Staff use project EBG to guide care for their late preterm newborns
Data collection tools completed prior to newborn discharge: Newborn data collection tool
Mother knowledge questionnaire
©2009 AWHONN
Post- ImplementationPost- Implementation
Case-scenario-based integration post-test: Evaluate critical thinking and integration of
knowledge of LPI care following nurse education and EBG implementation
Nurse Perception Survey: Evaluate nurses’ overall opinions of the project,
knowledge gained, degree of success implementing the EBG, facilitators, barriers, perceived change in practice.
©2009 AWHONN
Data Collection, Analysis, Data Collection, Analysis, Reporting 2009 - 2011Reporting 2009 - 2011
Data collection through 2009, early 2010
Analysis through 2010
Publication of results in AWHONN journals in late 2010-2011
Publication of the refined Evidence-Based Guideline in 2010
©2009 AWHONN
SummarySummary
Late Preterm infants are a major focus of our specialty care
AWHONN has developed several resources and programs to provide nurses with information that will improve the quality of care provided to these infants.
The LPI EBG is really the culmination of AWHONN’s work to ensure we are guiding practice with best available evidence.
The Research-Based Practice Project and the LPI EBG will also provide information about what works successfully to help providers implement evidence-based care.
©2009 AWHONN
Thank YouThank You
Questions?
For more information on the Late Preterm Infant Initiative contact:
Brea Samuel, MPH
Research Project Coordinator
