Rhonda Lanning DNP, CNM, LCCE, IBCLC, RN from University of North Carolina, Chapel Hill, presented to our PQCNC teams on their success of running a volunteer doula program in October, 2019. This month, she published an evaluation of this volunteer program in the Journal of Obstetric, Gynecologic, & Neonatal Nursing. The article outlines the program and shares how the demand for doulas increased exponentially over a 6-year time-frame. From 2012 to 2018, there was a 315% increase in the number of women supported in an L&D room. The published evaluation of the program underscored the rapid growth of the project, high levels of patient satisfaction with doula care, and nurses noted positive experiences partnering with volunteer doulas. Other PQCNC teams in the state have already begun planning their own volunteer doula program as a result of Rhonda sharing her knowledge and resources aimed at reducing primary cesareans.
Updates
The second learning session for the PQCNC AIM Reducing Primary Cesarean delivery initiative was held on October 24, 2019. Gail Tully, the founder of Spinning Babies, was the keynote speaker and provided insight on physiologic labor support. She instructed attendees on positions to support vaginal birth and provided handouts for attendees to take home and share with colleagues.
Amanda Walker, a former NICU parent who experienced a traumatic delivery, shared her experience and provided insights on improvement. Mary Cascio, the Director of Women’s from Mission hospital presented on a new staffing model for labor and delivery units that better allocates resources a times of higher census. Rhonda Lanning shared a pathway and the benefits to implementing a volunteer doula program and Dr. Arthur Ollendorff highlighted multidisciplinary collaborative efforts in performing family centered cesarean deliveries.
See those presentations here
As the North Carolina state leader promoting maternal safety in partnership with the Alliance for Innovation on Maternal Health (AIM), PQCNC is educating teams on best-practice to reduce primary cesarean births. Adhering to the AIM metrics, teams are encouraged to track provider education on the ACOG/SMFM labor management guidelines that include teaching on the Safe Reduction of Primary Cesareans.
Admittedly, tracking education for physicians is not a role many providers have time to commit too. However, one MD did just that in Wilmington, NC. Dr. Jeffery Stinson, the highly engaged physician lead for the PQCNC RPC project at New Hanover Regional Medical Center, took the initiative and created education for their providers focused on evidence provided by The American College of Obstetricians and Gynecologists. Not only did he take the time to create the education, he worked with their internal education department to ensure the education would be mandatory for all providers, including residents, and included a quick post-test to track knowledge and compliance upon completion. By partnering with his nurse leaders to ensure a multi-disciplinary approach is achieved, his commitment and dedication is making a difference in reducing primary cesareans in eastern North Carolina.
As we continue to provide labor support education in every perinatal region across North Carolina, a third class was held in Winston Salem at Novant Forsyth Medical Center. Taught by midwife, Tina Hayes, with assistance from midwives Leigh Anne Smith and Tamara Brothers, nearly 40 nurses were given instruction and advice on how to partner with women to provide labor support to increase vaginal delivery. A highlight of the day was four nurses who previously attended a PQCNC labor support class in Charlotte, NC sharing their experiences of how they recently incorporated support techniques learned during the class. Not only were they successful in achieving vaginal deliveries, they were also able to demonstrate the value of that knowledge to providers who subsequently requested their presence for labor support at additional deliveries. The enthusiasm and feelings of empowerment and gratification demonstrated by the nurses was contagious. Three more labor support classes are scheduled in Raleigh, Wilmington and Asheville, North Carolina.
One of the elements of the PQCNC AIM RPC Action Plan is for teams to provide patient education on healthy labor and birth. There are a handful of teams who currently provide such information and the team at CaroMont is one of them. They utilize an infographic from Lamaze International titled “Six Steps to a Healthy and Safe Birth.” CaroMont provides this information during childbirth education classes but it is also pertinent for mothers to receive upon admission. It can provide education and promote discussion regarding methods to support vaginal birth.
AUGUST 23rd-REGION II
Forsyth Medical Center
3333 Silas Creek airway
Winston-Salem, NC 27103
Charter Hall in the NHFMC Conference Center
Parking is free. Park in parking deck
Register here
SEPTEMBER 16- REGION IV
UNC Rex Hospital
Rex Heart & Vascular Building
2800 Lake Boone Trail, Raleigh NC.
Auditoriums A&B located on the first floor of the Heart & Vascular building
Parking is free and participants can park in H&V parking garage More Information to follow.
OCTOBER 9- REGION V
SEAHEC
2511 Delaney Avenue
Wilmington, NC 28403
Pelican Room
Parking is free in a designated lot at 2514 Delaney Avenue, diagonally across from the SEAHEC building. Attendees are to park in this space then access the building through the front doors facing Delaney. More Information to follow.
OCTOBER 17- REGION I
MAHEC
More Information to follow.
Earlier in May, PQCNC facilitated a labor support workshop in Greenville, NC and on May 20 a workshop was held in Charlotte, NC at the Atrium main campus. Nearly 65 obstetric providers gathered to learn labor support techniques and the physiology behind what makes them effective. The workshop was taught by midwives Tina Hayes and Sage Brook. The physician perspective of labor support and how best to communicate labor progress with providers was also provided. After a discussion of various labor support techniques and viewing instructional videos, participants were able to experience hands on practice of the techniques with continued guidance provided by the instructors. Instructors and participants were able to share their personal experiences along with hints, tips and tricks of what nurses can do to facilitate labor support and provide women with the childbirth experience they desire.
Nearly 50 obstetric providers gathered at Vidant Medical Center for a PQCNC workshop to learn labor support techniques and the physiology behind what makes them effective. The workshop was taught by midwives Kay Mitchell and Jomeka Mowery and childbirth educator Jennifer Kendrick. After a discussion of various labor support techniques and viewing instructional videos, participants were able to experience hands on practice of the techniques with continued guidance provided by the instructors. Additionally, patient educational materials were supplied along with hints, tips and tricks of what nurses can do to facilitate labor support and provide women with the childbirth experience they desire.
Teams have asked and PQCNC has listened! We are excited to announce PQCNC will be partnering with experts from across the state to offer RPC teams 2 regional meetings in May focused on labor management. These will be all day sessions beginning at 9 AM. Lunch will be provided and there is no charge for participating hospitals. Registration links are below and these meetings are right around the corner, so don’t wait...spread the word! We hope to see you there.
To Register for the Eastern Regional Meeting on May 8th, click here
To Register for the Western Regional Meeting on May 20th, click here
Lake Norman Regional Medical Center (LNRMC) has made tremendous strides in reducing their primary cesarean section rate in the last few years. LNRMC is located in Mooresville, North Carolina and delivers approximately 800 babies per year. The staff at LNRMC have worked diligently to incorporate many elements of the AIM Reducing Primary Cesarean Section maternal safety bundle and they have shared their success story with all PQCNC teams participating in the AIM Reducing Primary Cesarean Section initiative. Arin McClune, the Perinatal Program Coordinator at LNRMC, recorded a brief webinar discussing the elements of the maternal safety bundle that have made the most impact on their primary cesarean section rate. The webinar, titled Reducing Primary Cesarean Deliveries in Hospitals with less than 1000 deliveries per year, can be found here.