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Implementation of a Substance Use Di...

Cummings, Jordan.

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Implementation of a Substance Use Disorder Bundle at a Birth Center: A Quality Improvement Project.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Implementation of a Substance Use Disorder Bundle at a Birth Center: A Quality Improvement Project./
Author:	Cummings, Jordan.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2023,
Description:	59 p.
Notes:	Source: Dissertations Abstracts International, Volume: 84-11, Section: A.
Contained By:	Dissertations Abstracts International84-11A.
Subject:	Obstetrics. -
Online resource:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=30421490
ISBN:	9798379448240

Implementation of a Substance Use Disorder Bundle at a Birth Center: A Quality Improvement Project.
Cummings, Jordan.

Implementation of a Substance Use Disorder Bundle at a Birth Center: A Quality Improvement Project. - Ann Arbor : ProQuest Dissertations & Theses, 2023 - 59 p.

Source: Dissertations Abstracts International, Volume: 84-11, Section: A.

Thesis (D.N.P.)--Georgetown University, 2023.

This item must not be sold to any third party vendors.

A quality improvement (QI) project spanning 10 weeks introduced a substance use disorder (SUD) patient care bundle for peripartum individuals at a midwifery-operated birth center with no preexisting standardized screening for SUD in the workflow. The project aimed to observe the effect of bundle implementation on provider screening, brief Intervention, and referral to treatment (SBIRT) practices as well as feasibility and sustainability of bundle implementation. Staff and certified nurse-midwives (CNMs) received education on SUD, SBIRT, and bundlerelated workflow changes. Universal SUD screening utilizing the 5P Prenatal Substance Abuse Screening tool, motivational interviewing (MI), and a referral process was integrated into the workflow for new obstetrical (NOB), new obstetrical transfer (NOBT), and postpartum (PP) encounters. Pre- and post-implementation chart audits were performed to assess CNM adherence and documentation of SBIRT in eligible encounters. Surveys were conducted to evaluate the birth center staff and CNMs perceived efficacy of the pre-implementation bundle education as well as feasibility and sustainability of bundle implementation at the birth center. Following implementation of the bundle, 84.5% of eligible patient encounters had a CNM-documented SBIRT screening in the electronic medical record (EMR), compared with 3% of encounters in the pre-implementation group, indicating a statistically significant increase (p < 0.001). All preimplementation screening encounters were documented as low risk. Of eligible postimplementation encounters, 98% were documented as low risk, and 2% of screenings had no risk score documented in the EMR. Following implementation, 83% of eligible encounters screened and assigned a risk level received a risk level appropriate intervention from the midwife, including brief advice or reinforcement of behavior. Overall, staff and CNMs strongly agreed that the in-service education provided adequate information on SBIRT and workflow changes associated with the bundle. Post-implementation, data and survey responses demonstrated that the workflow changes associated with bundle implementation were feasible and sustainable at the birth center. Implementation of an evidence-based SUD Patient Care Bundle is a feasible and sustainable practice change for a CNM-led birth center. The Midwifery Model of Care promotes adherence to patient-centered screenings and interventions surrounding SUD.

ISBN: 9798379448240Subjects--Topical Terms:

634501
Obstetrics.
Subjects--Index Terms:

Bundle

Implementation of a Substance Use Disorder Bundle at a Birth Center: A Quality Improvement Project.
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520 $a A quality improvement (QI) project spanning 10 weeks introduced a substance use disorder (SUD) patient care bundle for peripartum individuals at a midwifery-operated birth center with no preexisting standardized screening for SUD in the workflow. The project aimed to observe the effect of bundle implementation on provider screening, brief Intervention, and referral to treatment (SBIRT) practices as well as feasibility and sustainability of bundle implementation. Staff and certified nurse-midwives (CNMs) received education on SUD, SBIRT, and bundlerelated workflow changes. Universal SUD screening utilizing the 5P Prenatal Substance Abuse Screening tool, motivational interviewing (MI), and a referral process was integrated into the workflow for new obstetrical (NOB), new obstetrical transfer (NOBT), and postpartum (PP) encounters. Pre- and post-implementation chart audits were performed to assess CNM adherence and documentation of SBIRT in eligible encounters. Surveys were conducted to evaluate the birth center staff and CNMs perceived efficacy of the pre-implementation bundle education as well as feasibility and sustainability of bundle implementation at the birth center. Following implementation of the bundle, 84.5% of eligible patient encounters had a CNM-documented SBIRT screening in the electronic medical record (EMR), compared with 3% of encounters in the pre-implementation group, indicating a statistically significant increase (p < 0.001). All preimplementation screening encounters were documented as low risk. Of eligible postimplementation encounters, 98% were documented as low risk, and 2% of screenings had no risk score documented in the EMR. Following implementation, 83% of eligible encounters screened and assigned a risk level received a risk level appropriate intervention from the midwife, including brief advice or reinforcement of behavior. Overall, staff and CNMs strongly agreed that the in-service education provided adequate information on SBIRT and workflow changes associated with the bundle. Post-implementation, data and survey responses demonstrated that the workflow changes associated with bundle implementation were feasible and sustainable at the birth center. Implementation of an evidence-based SUD Patient Care Bundle is a feasible and sustainable practice change for a CNM-led birth center. The Midwifery Model of Care promotes adherence to patient-centered screenings and interventions surrounding SUD.
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653 $a Screening
653 $a Substance use
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