| Description |
Currently, the Centers for Disease Control and Prevention report the neonatal death rate at 4.5 per 1,000 births. This is a significant decrease from the rate of 20.5 per 1,000 reported in the 1950's. While this is an impressive decrease, fetal demise, defined as any fetal or neonatal death after 20 weeks gestation and before 30 days of life, continues to occur. Labor and delivery nurses are often the health care professionals responsible for the care of women, families and the deceased infant during a fetal demise. Additionally, rural nurses are met with challenges specific to their rural setting. Such challenges include an extended scope of practice, visibility within the community, and fewer resources and educational opportunities. Fetal demise is an emotional event that requires compassionate and therapeutic care. Rural nurses lack educational resources needed to learn how to best care for patients during these difficult times. This lack of education leads to increased anxiety and may negatively impact patient care. The objectives of this project were as follows. First, I assessed the current knowledge base, knowledge deficits, and desired education regarding care following fetal demise amongst labor and delivery nurses in Cody, Wyoming via an online survey. Second, I developed and presented and educational module addressing the identified needs at the labor and delivery nurses' staff meeting. Third, I assessed changes in knowledge and comfort levels regarding post demise care by administering a post-test survey. Next, I modified the educational module according to the post-education survey. And lastly, I added the educational module to new nurse orientation and made it available for reference in the event of a fetal demise. According to survey results, only one third of respondents had received any formal training regarding fetal demise care. Most nurses had cared for patients experiencing fetal demise, but only 55% had cared for a deceased infant. Results from the post-education survey indicated that the education decreased feelings of dread and anxiety by half and that comfort levels increased. Additionally, knowledge regarding basic facts relating to fetal demise increased significantly. It was noted that nurses most appreciated learning what resources are available to them and their patients. Internet resources are especially beneficial to rural communities that lack local resources. This project assists labor and delivery nurses in preparing to care for families following a fetal demise. This decreases their anxiety and allows them to deliver high quality, therapeutic care to their patients throughout these difficult situations. |
