Implications for Nursing Practice

Identi¢cation of the unique needs of postpartum wo-

men experiencing long-term bed rest for antepartum

complications has facilitated development of stan-

dards of care speci¢c to this population that include

physical, psychological, and social components and

may serve as a model for health care organizations.

Perinatal Support: Helping Pregnant Women Fight

Mood and Anxiety Disorders

Poster Presentation

Purpose for the Program

Women are more likely to experience depres-

sion during childbearing years than any

other time in their lives, and15% of all women will ex-

perience postpartum depression after giving birth.

Another 20% will experience depression symptoms

during pregnancy. When a mother’s mental health is

compromised, the entire family is a¡ected.

Many women with pre- and postpartum depression

are not receiving treatment, thereby prolonging

their condition and disconcerting emotions.

Proposed Change

Patients must seek help when they are depressed,

and many do not know where to turn. They may feel

awkward or uncomfortable discussing their emo-

tions. Wanting to help patients through this critical

time, Reynolds Army Community Hospital devel-

oped a screening process for depression. They

created a support group using Cognitive Behav-

ioral Therapy designed to help with depression

during pregnancy and postpartum.

Implementation, Outcomes, and Evaluation

Patients were told about the group at obstetric

(OB) orientation and then screened at 28 weeks

pregnancy, 2 weeks postpartum, and 6 weeks post-

partum. Very few patients attended the support

group, and Reynolds was considering dropping

the class but decided to try once more to make this

class a success, believing that their patients

needed the support.They decided to send informa-

tion about their pre- and postpartum support group

through their weekly e-mail service in addition to

notifying patients during OB orientation and

throughout their pregnancies. Through electronic

communications, patients receive educational in-

formation and resources every week from their

care team. Within 1 month, Reynolds reached its

goal of having 8 to 10 patients at the support group,

with exciting behavioral results. They now consis-

tently have 10 or more patients in the group, both

active duty and civilians.

Implications for Nursing Practice

To date, there is no de¢nitive prevention for pre- or

postpartum depression; however, having a solid

social support system through Reynolds’ support

group has shown to help reduce the severity of de-

pression, while empowering patients with coping

skills. Early identi¢cation and intervention have

been shown to improve long-term diagnoses for

most women. Reaching women through our e-mail

service at the precise moments when they need

support and guidance, Reynolds Army Community

Hospital is able to help many women through this

di⁄cult and emotional time.

They May Be Young, They May Be Healthy . . .

So . . . Why Do They Fall?

Poster Presentation

Purpose for the Program

Todiscuss the implementation of a fall reduction

program and a fall risk assessment tool that

would be appropriate to the obstetrics (OB) popula-

tion. The program is based on the normal

pregnancy-related physiological changes known

to increase the risk for accidental falls, unantici-

pated falls, or even an anticipated fall during

pregnancy and postpartum.

Lisa Singleton, RN, BSN,

SANE-A, Department of Spe-

cialty Care Clinics, Reynolds

Army Community Hospital,

Ft. Sill, OK

Keywordsperinatal depressionpostpartumpostpartum depressionperinatal supportdepressioncognitive behavioral therapy

Childbearing

S12 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

Proposed Change

To reduce patient harm from a fall through fall risk

assessment and education of nursing sta¡ and

families.

Implementation, Outcomes, and Evaluation

Our institution complied withThe Joint Commission

(TJC) requirement to implement a fall reduction pro-

gram and complete a fall risk assessment on

admission, upon transfer to another level of care,

and when there is a change in condition. OB pa-

tients, not considered to be at high risk for fall,

were included in the guidelines but with minimal in-

put from the OB sta¡. Once the fall reporting system

was in place, fall events indicated that the OB pop-

ulation was no longer at low risk for fall but just as at

risk for fall as a 65 year old. Reports were reviewed

and themes and opportunities were identi¢ed for

fall risk education of both nursing sta¡ and pa-

tients. A review of the literature identi¢ed available

fall risk assessment tools, and a user friendly tool

was identi¢ed. The initiative is continually being

evaluated through sta¡ feedback and from the in-

stitution’s fall reporting system.

Implications for Nursing Practice

Fall interventions for the OB patient are similar to all

age groups but one must consider that the postpar-

tum patient is also the primary caregiver in the

family centered care environment. Reducing falls

during hospitalization is of great importance, yet

equally important is reducing the incidence of acci-

dental falls during pregnancy through education

and increased awareness by the health care pro-

vider. The presentation is geared not only to the

bedside nurse, but also to health care providers

from all care settings.

Create Lasting Memories

Poster Presentation

Purpose for the Program

Perinatal loss at any gestation can be devastat-

ing to a family. Memory Box contents are all

some families take home with them when they leave

the labor and delivery unit of their hospitals. These

families are often seeking a way to put hopes and

dreams of what could have been into memories that

create meaning. Visual memories of the infant can

help in the healing process.

Proposed Change

Parents who experience a perinatal loss describe

deep feelings of the importance of photographs

because they provide unquestionable proof of

their infants’ existence. Getting photographs was

rated as one of the most helpful services ex-

tended to parents during a hospital stay ¢lled with

grief and mourning. Further research o¡ers evi-

dence that parents want photographs that are

clear and show the baby in a close up view, so

facial details can be seen. The number of photos

is not as important to the parents as the quality

and content.

Implementation, Outcomes, and Evaluation

It is common practice for hospitals to take photo-

graphs of infants after death. Instant photos are

typically taken and added to the memory box. Po-

laroid terminated camera production and instant

¢lm in 2009, creating a need to acquire an alternate

means of instant photography. Members of a be-

reavement council in a tertiary labor and delivery

unit were inspired to forge into a new digital direc-

tion for photos placed in the memory box of

perinatal loss patients.

After purchasing a digital camera, memory card,

and printer, the 1001 nursing sta¡ was educated

on how to operate them in order to create special

visual memories. Next, a survey was made avail-

able for nurses to express their comfort level

with using the camera/printer and to comment

on the quality of the photographs. Most describe

the photos as much sharper and more detailed

than the Polaroid instant photos previously pre-

sented to families. Once the sta¡ achieves a high

level of camera comfort, burning CD’s of the printed

photos is the next endeavor. This will allow for an

increased number of photographs and will last

forever.

Implications for Nursing Practice

Perinatal death is now recognized as a profound

event for surviving parents. Going digital o¡ers the

opportunity to a¡ord a su⁄cient number of excellent

quality photographs that will provide a sense of com-

fort as families begin to deal with perinatal loss.

Nancy Skinner, MSN, RNC,

Women’s & Children’s Ser-

vices, Christiana Care Health

Services, Newark, DE

Donna Smith, MSN, RNC-OB,

Women’s and Children’s Ser-

vices, Chistiana Care Health

System, Newark, DE

Keywordsfall risk assessmentMorse Fall Scoring System

Childbearing

Cheryl Swift, RNC, MSN,

Christiana Care Health

System, Newark, DE

Katherine L. Scott, BSN, RN,

Labor & Delivery, Christiana

Care Health System,

Newark, DE

Keywordsperinatal lossperinatal deathmemory boxbereavement

Childbearing

JOGNN 2011; Vol. 40, Supplement 1 S13

Swift, C. and Scott, K. L. I N N O V A T I V E P R O G R A M S

Proceedings of the 2011 AWHONN Convention