HQ004 Innovations to Improve Outcomes

HQ004 Innovations to Improve Outcomes

Student Name

Western Governors University

D026 Quality Outcomes in a Culture of Value-Based Nursing Care

Prof. Name:

Date

Identified Problem

During labor, monitoring the fetal heart tones (FHT) is crucial to ensure the wellbeing of the fetus. However, the current facility relies solely on traditional wired FHT monitors, which restrict patients’ mobility to a limited range near the equipment. This limitation negatively impacts labor as continuous wired monitoring reduces maternal mobility and confines laboring women to restricted positions. Research indicates that around 60% of women are prevented from moving freely during labor, despite evidence supporting mobility as a natural and beneficial physiological process for childbirth (Watson, Mills, & Lavender, 2022; Ondeck, 2019).

What are the effects of limited mobility during labor?

Limited mobility during labor can result in several adverse effects. It contradicts established healthy birth practices that encourage walking, changing positions, and moving throughout labor, which are associated with reduced labor duration and improved birth outcomes. The high intervention rate during labor, including restrictions on mobility, has been linked to an elevated cesarean section rate of 32% in the United States (Ondeck, 2019).

Research Article #1: Mobility During Labor

Ondeck (2019) emphasizes the importance of supporting physiological childbirth by promoting mobility and allowing women to choose their own labor positions. The article discusses the negative consequences of high intervention rates in labor and supports walking and upright positions as methods to shorten the first stage of labor and reduce complications. Encouraging movement reduces the risk of unintended harm and enhances the natural childbirth experience.

Research Article #2: Telemetry and Patient Experience

Watson, Mills, and Lavender (2022) examined the use of telemetry—wireless fetal heart monitoring—and its impact on laboring women and midwives. Their mixed-methods study found that telemetry significantly increases maternal mobility and allows women to adopt a wider range of positions during labor. This enhanced freedom promotes a sense of control, dignity, and autonomy. Moreover, the study observed lower epidural rates, indicating a more positive labor experience associated with telemetry use.

Research Article #3: Novii Wireless Patch System

The National Institute for Health and Care Excellence (2020) reported on the Novii Wireless Patch System, an innovative wireless device designed for maternal and fetal monitoring. Compared to traditional wired monitors, the Novii system offers increased effectiveness, especially in patients with higher body mass index (BMI). This wireless solution has the potential to reduce reliance on invasive fetal heart monitoring techniques and improve comfort during labor.

Proposed Innovation: Wireless Electronic Fetal Monitoring

What innovation is proposed to address the problem?
To overcome the limitations of wired monitors, the implementation of wireless electronic fetal monitoring devices, specifically the Novii Wireless Patch System, is proposed. This device offers greater freedom of movement and improved fetal heart tone tracing quality, particularly benefiting patients who are obese or have contraindications to internal monitoring.

How does the Novii Wireless Patch System address current challenges?

The Novii system enhances fetal monitoring by providing flexible electrode placement, which is especially useful for women with higher BMI. This flexibility improves the accuracy and reliability of fetal monitoring. Additionally, it supports laboring women’s mobility, which aligns with the physiologic birth practices recommended by research. Before adopting this technology, it is crucial to assess the organization’s readiness for change, address perceived barriers and benefits, and prepare staff for implementation.

Innovation Impact

Wireless monitoring technologies such as the Novii system promote increased maternal mobility, allowing for more natural labor positions. This can lead to better labor outcomes and enhanced patient satisfaction. The system also produces superior FHT tracings compared to standard monitors and reduces the need for more invasive monitoring methods, thereby improving both safety and comfort during labor.

Innovation Application: Steps for Implementation

Implementation Changes

Successful implementation requires involving staff and stakeholders throughout the process to foster ownership and engagement. Sustainable management of the wireless monitoring technology depends on understanding organizational readiness and addressing challenges proactively. Continuous evaluation and quality improvement initiatives will support long-term success (Brach, 2017; Rangachari, 2018; van Gemert-Pijnen, 2022).

References

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

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

HQ004 Innovations to Improve Outcomes

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

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