The purpose of this project was to determine if prenatal education on umbilical cord blood (UCB) banking had an impact on decision making and UCB donations. Cord blood has previously been considered a waste product that was thrown away with the placenta and is now recognized as having potentially life-saving hematopoietic stem cells. Cord blood is also considered regenerative medicine and every year medical trials test new therapies using UCB. Collection is a safe and simple procedure for both mother and newborn. Storing UCB in banks has become an important factor in treating diseases, protecting health, and improving patient outcomes. Increasing UCB donations has the potential to improve clinical outcomes for those individuals requiring stem cells from UCB. The project was based upon two clinical questions identified in regards to relationships with UCB banking knowledge and decision making with an educational intervention as opposed to no intervention.
Methods:
The project utilized a quantitative methodology with a quasi-experimental design (one group, pre and posttest design) using a pre and post survey to assess the impact of an educational intervention on UCB banking. A quasi experimental design was appropriate to use to determine the relationship of cord blood decision making after an educational intervention as compared to decision making without an educational intervention. The design chosen answered the clinical question in this project by using the data obtained from the pre and post survey to produce statistical evidence of any impact the educational intervention on UCB had on banking. In this project, one group was used with data being collected prior to an educational intervention using the pre-survey tool to determine previous knowledge on UCB and then the same survey was given and collected after the educational intervention. Participants in the project included 63 pregnant female individuals registered for childbirth education classes at three acute care facilities in the southwestern section of the United States where the project took place. Data was collected (surveys) and compared. Measurement occurred by using mathematical/statistical means to measure before and after an educational intervention on UCB banking for pregnant women. Frequency distribution was used to determine the impact of an educational intervention on UCB banking has on knowledge and decision making of UCB banking. A McNemar Test was also utilized with comparisons done on the same sample. This design determined if the educational intervention was effective in assisting with UCB decision making and answered the clinical questions.
Results:
The results produced by this project showed the educational intervention on UCB banking increased knowledge and decision making regarding UCB banking donations. At the conclusion of the data analysis, it was determined a total of 63 participants who attended childbirth education received the educational intervention. Of the 63 respondents, 45 (71.4%) noted on the pre survey that they would not bank UCB and the remaining 18 (28.6%) responded they would bank either privately or publicly. The post survey revealed 13 (20.6%) would not bank with the remaining 50 respondents stating they would bank UCB. The change was all positive; the shift was entirely in respondents changing from no to yes, none in the reverse. The data concluded that the educational intervention on UCB actually had a positive impact on knowledge and decision making regarding UCB banking. Statistical significance was attained by the McNemar Test. McNemar’s Test, χ2(1) = 30.03, p < .001, indicated the shift from deciding to not bank to bank cord blood was statistically significant; 50 respondents out of 63 participants stating they would bank UCB in the post survey.
Descriptive analysis using both pre survey and post survey results also supported a positive relationship between the variables tested. Descriptive data was statistically significant with only four participants responding with banking having too many unknowns to be of high value after an educational intervention; displaying an increase in knowledge in the high value of UCB banking. No participant was unaware of UCB banking as an option after the educational intervention.
The findings of this project are meaningful and support efforts on the need of accurate and unbiased UCB banking information in childbirth education classes. The results of this project can be used to address the value of UCB banking to increase donations and potentially save the lives of those individuals requiring UCB stem cells
Conclusion:
The project contributed to nursing practice and recommendations by the IOM on the need for accurate information on UCB options into practice. Implementing additional educational information on UCB has the potential to assist individuals in decision making on UCB and increasing the amount of UCB donations to save the lives of those individuals requiring UCB stem cells.
This project was beneficial and worth conducting because it explored the need for accurate, unbiased, evidenced based information to be given to expectant parents during pregnancy to educate on the value of UCB and decrease the amount of UCB discarded as waste. The project was distinctive with the attention on prenatal childbirth education. The project added to the current body of literature by connecting approaches/strategies to further enhance the knowledge and value of UCB banking to expectant parents and expanding the amount of donations of UCB through educational efforts in prenatal childbirth education classes. Impact or value to the population, community, and society was addressing the value of UCB and need for donations to save the lives of those needing UCB stem cells. The project was in agreement with the report issued to Congress in 2005 regarding recommendations that health care workers provide all expectant parents with accurate, balanced, and fair education on UCB banking. Recommendations for practice would include standardized UCB banking education in childbirth classes and to educate childbirth educators on current information that is evidenced based.