Prenatal Registry Program Knowledge Translation (KT) Northern Health Initial Six Primary Care Integration Sites: Prince George, Mackenzie, Fraser Lake, Valemount, Prince Rupert and Fort St. John Vanessa Salmons, BSN, RN, Sharon Davalovsky, Preventive Public Health Regional Manager & Linda Axen, NRF, Northern Health.; Sarah Tod & Callie Waters, University of Northern BC Health Science Students; Pam Mulroy, University of Victoria Masters Student
Introduction The Northern Health Prenatal Registry Program (PRP) is an integrated, collaborative healthcare effort by primary care providers and public health nursing, aimed at moving public health efforts upstream to improve maternal, child and family health. A program evaluation was undertaken to gain information and insight about the program and its ability to meet the needs of pregnant women and their families.
Results Data Results: •545 pregnant women registered (39% of births in participating communities) •489 women registered and delivered their infants (29%). Differences due to women lost to follow-up, perinatal loss or leaving the community
Figure 1: Percentage of Registered Women Reporting Risk Factors
The PRP is an innovative practice to implement the services outlined in the Provincial Healthy Start Initiative to connect public health with prenatal women and families early in pregnancy. Public Health Nurses (PHNs) aim to connect early with all pregnant women, especially those living in conditions of poverty, depression and/or tobacco/substance use.
Based on an analysis of the data, seven recommendations and future strategies were formulated from the findings to support program improvements and the expansion of the PRP throughout the Northern Health region: 1.Communication
An evaluation was completed after the program had been implemented for one year in six communities. The purpose of the evaluation was to hear participants’ stories of their experiences with the program and its ability to meet their needs. Figure 2: Registered Women reporting Multiple Risk Factors
& Collaboration 2.Program Promotion – Increase Referrals & PHN connection for pregnant women 3.Client/Provider Relationship – supports 4.PHN Education 5.Information Sharing 6.Prenatal Registration Questionnaire (self-referral) 7.Follow-up Care Pathways & Protocols
KT Strategies
Methods
Synthesis • This evaluation project facilitated the development and promotion of a collaborative relationship between researchers (academia/students) & decision-makers (practice/NH organization) • Integration of evaluation findings within the PRP Evaluation Report
Quantitative Data • Data collected from the prenatal registration questionnaire (self-referral) that is distributed through primary care and returned to public health •PHNs entered information into the PRP database/surveillance spreadsheets
Qualitative Data – Student project collaborative initiative •Client survey administered to registered women who had delivered their infants in each of the six communities (electronic & paper format) •Care provider survey administered on-line during a two week period •2 focus groups facilitated within the region
•27 responses to the online care provider survey from all six communities (from snowball sampling technique) •Various care provider roles were represented •82% believe the program supports the continuum of care for mother and baby •33 % agreed that the service is adequately promoted and accessible •59% believe the program is successful in referring vulnerable pregnant women to appropriate community agencies and services
Discussion
Background
NH saw the opportunity for collaboration with a graduate student from the University of Victoria and undergraduate students from the University of Northern BC to complete the qualitative evaluation components of the broader evaluation project.
Care Provider Survey Report:
Client Survey Report: •284 surveys sent out and 41 returned (14% return rate) •21 surveys available for student report; 20 additional surveys returned late •70-85% of respondents were satisfied with the PRP and felt supported to have a healthy pregnancy Figure 4: “Did you feel the Prenatal Registry Program supported you during your pregnancy?
Exchange • Dissemination of PRP Report to NH stakeholders & leadership • Identification of key recommendations for program improvement Application of Knowledge • Formulation of a multidisciplinary Strategy Network team to prioritize and plan the implementation of the recommendations to support pregnant women and their families to ensure healthy pregnancies and birth outcomes