HQ004 Innovations to Improve Outcomes

Student Name

 University

NURS 6231 Healthcare Systems and Quality Outcomes

Prof. Name

Date

Identified Problem

During labor, there is a need for varying degrees of fetal heart tone (FHT) monitoring. The facility only has the use of traditional wired monitors, which limits patients to staying within a few feet of the monitoring system. Continuous FHT monitoring with wires decreases mobility and limits positions for labor (Watson et al., 2022). Approximately 60% of women are denied mobility during labor, which contradicts the support for mobility as a natural physiologic process for birth (Ondeck, 2019).

Research Article #1

Ondeck M. (2019). Healthy birth practice #2: Walk, move around, and change positions throughout labor. The Journal of Perinatal Education, 28(2), 81–87. https://doi.org/10.1891/1058-1243.28.2.81

This article highlights the negative impact of high intervention during labor on the high U.S. c-section rate of 32%. It advocates for the use of physiologic childbearing and mobility during labor. Key takeaways include promoting mobility during labor to reduce unintended harm, allowing women to choose their own positions during labor, and the benefits of walking and upright positions in reducing the length of the first stage of labor.

Research Article #2

Watson, K., Mills, T.A. & Lavender, T. (2022). Experiences and outcomes on the use of telemetry to monitor the fetal heart during labour: findings from a mixed methods study. Women and Birth, 35(3), 243-e252, https://doi.org/10.1016/j.wombi.2021.06.004.

This study investigates the experiences of patients and midwives using telemetry for fetal monitoring during labor. Telemetry allowed for increased mobility and provided opportunities for an improved experience, supporting physiological capabilities. Key takeaways include greater mobility and a wider range of positions, increased sense of control and dignity, and lower epidural rates associated with telemetry use.

Research Article #3

National Institute for Health and Care Excellence. (2020). Novii wireless patch system for maternal and fetal monitoring. https://www.nice.org.uk/advice/mib228/resources/novii-wireless-patch-system-for-maternal-and-fetal-monitoring-pdf-2285965518732997

This summary discusses the use of the Novii Wireless Patch System for maternal and fetal monitoring, emphasizing its innovation and effectiveness compared to traditional wired monitors and belts. Trials showed effectiveness in patients with an increased body mass index, with potential to reduce the use of more invasive methods of FHT monitoring.

Proposed Innovation

Proposal: Implement the use of wireless electronic fetal monitoring devices for patients during labor, specifically the Novii Wireless Patch System.

Addressing the Problem

The Novii Wireless Patch System addresses the difficulty of monitoring FHT and uterine contractions in women who are obese, offering greater control over electrode positioning. Before implementation, readiness for change within the organization must be ensured, understanding perceived barriers and benefits and how the innovation affects them.

Innovation Impact

The use of wireless monitoring allows for greater mobility, provides superior FHT tracings compared to standard monitors, and offers advantages for patients with contraindications to internal monitoring. It improves women’s experience and physiological capability during labor.

Innovation Application

Steps for implementing the Novii Wireless Patch System include approval and acceptance by the organization, assessment of current monitors for compatibility, procurement and training on the new technology, and ongoing quality monitoring.

Implementation Changes

Involving staff and stakeholders in the development and measurement of the innovation, ensuring commitment and investment in sustainable technology management, and assessing organizational readiness for change are essential for successful implementation.

References

The American College of Obstetricians and Gynecologists. (2009). Intrapartum fetal heart rate monitoring: nomenclature, interpretation, and general management principles. Obstetrics and Gynecology, 114(1), 192–202. https://doi.org/10.1097/AOG.0b013e3181aef106

Brach, C. (2017, June 16). ‘Will it work here?’: Health systems need contextual evidence before adopting innovations. Health Affairs Blog. Retrieved from https://www.healthaffairs.org/do/10.1377/hblog20170616.060641/full/

NURS 6231 Assessment 4 HQ004 Innovations to Improve Outcomes

Johnson, J. K., & Sollecito, W. A. (2020). McLaughlin & Kaluzny’s continuous quality improvement in health care (5th ed.). Jones and Bartlett.

Monson, M., Heuser, C., Einerson, B. D., Esplin, I., Snow, G., Varner, M., & Esplin, M. S. (2020). Evaluation of an external fetal electrocardiogram monitoring system: a randomized controlled trial. American Journal of Obstetrics and Gynecology, 223(2), 244.e1–244.e12. https://doi.org/10.1016/j.ajog.2020.02.012

National Institute for Health and Care Excellence. (2020). Novii wireless patch system for maternal and fetal monitoring. https://www.nice.org.uk/advice/mib228/resources/novii-wireless-patch-system-for-maternal-and-fetal-monitoring-pdf2285965518732997

Ondeck, M. (2019). Healthy birth practice #2: Walk, move around, and change positions throughout labor. The Journal of Perinatal Education, 28(2), 81–87. https://doi.org/10.1891/1058-1243.28.2.81

Rangachari, P. (2018). Innovation implementation in the context of hospital QI: Lessons learned and strategies for success. Innovation and Entrepreneurship in Health, 5, 1–14. https://doi.org/10.2147/IEH.S151040

van Gemert-Pijnen, J. L. (2022). Implementation of health technology: Directions for research and practice. Frontiers in Digital Health, 4, 1030194. https://doi.org/10.3389/fdgth.2022.1030194

Watson, K., Mills, T. A., & Lavender, T. (2022). Experiences and outcomes on the use of telemetry to monitor the fetal heart during labor: Findings from a mixed methods study. Women and Birth, 35(3), 243-e252. https://doi.org/10.1016/j.wombi.2021.06.004

NURS 6231 Assessment 4 HQ004 Innovations to Improve Outcomes