HQ004 Innovations to Improve Outcomes NURS 6231 Healthcare Systems and Quality Outcomes Innovations to Improve Outcomes Identified Problem

 

During labor, there is a need for varying degrees of fetal heart tone (FHT) monitoring. The facility only has the use of traditional wired monitors, which limits patients to staying within a few feet of the monitoring system. Continuous FHT monitoring with wires decreases mobility and limits positions for labor (Watson et al., 2022). Approximately 60% of women are denied mobility during labor, which contradicts the support for mobility as a natural physiologic process for birth (Ondeck, 2019).

Research Article #1

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

Research Article #2

Watson, K., Mills, T.A. & Lavender, T. (2022). Experiences and outcomes on the use of telemetry to monitor the fetal heart during labour: findings from a mixed methods study. Women and Birth, 35(3), 243-e252, https://doi.org/10.1016/j.wombi.2021.06.004.

Research Article #3

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-pdf-2285965518732997

Proposed Innovation

Proposal

Implement the use of wireless electronic fetal monitoring devices for patients during labor, specifically the Novii Wireless Patch System.

Addressing the Problem

The Novii Wireless Patch System addresses the difficulty of monitoring FHT and uterine contractions in women who are obese, offering greater control over electrode positioning. Before implementation, readiness for change within the organization must be ensured, understanding perceived barriers and benefits and how the innovation affects them.

Innovation Impact

The use of wireless monitoring allows for greater mobility, provides superior FHT tracings compared to standard monitors, and offers advantages for patients with contraindications to internal monitoring. It improves women’s experience and physiological capability during labor.

Innovation Application

Steps for implementing the Novii Wireless Patch System include approval and acceptance by the organization, assessment of current monitors for compatibility, procurement and training on the new technology, and ongoing quality monitoring.

Implementation Changes

Involving staff and stakeholders in the development and measurement of the innovation, ensuring commitment and investment in sustainable technology management, and assessing organizational readiness for change are essential for successful implementation.

References

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