Improving Triage of Pregnant Women in the Urgent Care Setting

POSTER

Improving Triage of Pregnant Women in the Urgent Care Setting Emily Hansen, BSN, RN, DNP- FNP Student Dr. Victoria Prince, MD, PHD, Mandy Al-Khudairi, DNP, APRN, FNP-C, WHNP-BC, and Dr. Brett Einerson, MD, MPH, FACOG Key Findings: After participating in an education intervention on Obstetric (OB) Triage education, UC RNs reported improved knowledge and comfort with the triage and hand off of pregnant women who require transfer to OB Emergency Services (OBES). Education question scores improved significantly post education intervention. However, qualitative feedback shares concern for continued poor baseline training. Background Results Comfort Triaging Pregnant Women 50% 45% Women who are laboring, or suspect pregnancy complication present to Urgent Care (UC) locations within the University of Utah Community Clinics rather than OBES or other local labor and delivery units 81% (n=9) nurses participated in the pre-survey portion of the intervention 40% 35% 30% 25% 77% (n=7) nurses completed pre and post-survey following the education intervention 20% 15% Improper triage and poor interdepartmental transfer is linked to negative outcomes by delaying care and possibly increasing mortality and complications for both mother and fetus 10% On pre-survey 0% nurses felt comfortable with triaging pregnant women in UC. Re-evaluation response yielded an improvement of 35% (n=5) on post survey 5% 0% Pre Post Strongly Agree Agree Neutral Disagree Strongly Disagree Missing 0% 11% 22% 44% 22% 22% 44% 0% 11% 0% 0% 22% Pre Post Improvement Shown Post Training UC RNs have poor training on how to safely triage pregnant women and provide a concise, safe hand off to OBES staff Improved No N/A (no post) Participant’s overall education scores improved from Pre (N=9, M=4.4, SD=1.0) to Post (N=7, M=6.3, SD=0.8) with two individuals not completing the post questionnaire 22% 89% of UC RNs report they disagreed when asked if they were provided with proper OB Triage education during orientation Conclusions 11% 67% Methods QI project to assess and improve upon existing education and evaluate RN comfort with OB Triage Familiarity with OBES Pre Post 50% Education materials and triage toolkit were built using peer reviewed articles and content expert input With annual practice updates by educators, this project could be feasibly and sustainably implemented in other University of Utah UC Centers 44% 40% 33% 33% 33% 30% 22% Percent Education materials and toolkit introduction were disseminated to UC RNs individually or in groups of 2 22% 20% 11% 10% Implementation success was measured using pre and post-survey evaluation and data collection 0% -10% 0% 0 1 2 3 Reported overall comfort with OB triage, familiarity with OBES, confidence with documentation and hand off improved significantly between baseline and follow up survey post education intervention 0% 0% 0% 4 5 6 7 Qualitative feedback from nurses demonstrated a need to fill the gaps in education and provide a longterm, structured approach to OB Triage Strongly Agree Agree Neutral Disagree Strongly Disagree Missing COLLEGE OF NURSING