| Learning Objective #1: Describe the model of Advanced Practice Nursing in a prenatal Multiples Clinic | |||
| Learning Objective #2: Describe the nursing related outcomes associated with a model of Advanced Practice Nursing in a prenatal Multiples Clinic |
The Multiples Clinic at Sunnybrook and Women's was established in 1996 in response to marked increases in rates of multiple births and their inherent complications.
This was the first and continues to be the only specialized multiples referral clinic in Canada. Women are referred by a primary antenatal care provider who provides routine prenatal care throughout the pregnancy. Women receive specialized multiples care in the Clinic during the pregnancy between 16-34 weeks and then return to the primary caregiver and home hospital for delivery. Information is communicated by means of a patient-carried record.
The Clinical Nurse Specialist in the Multiples Clinic works within a multidisciplinary team to provide extensive education, support and anticipatory guidance for women and their families experiencing the special needs of a multiple pregnancy.
Previous studies of targeted populations have linked advanced practice nursing care with improved health outcomes, shorter lengths of stay, earlier discharge and integration into the community and increased satisfaction with care. Although the values and effectiveness of specialized multiples clinics have been demonstrated, none of the outcomes reported has been examined in the context of their relationship to advanced practice nursing care.
Data was collected on the following parameters: measures of emotional wellbeing and social support (Edinburgh Postnatal Depression Scale and Medical Outcome Study Social Support Survey), place of delivery (level II or level III centre) gestational age at delivery, incidence of high risk emergency transfer, nursing workload measured by numbers of hours of contact and patient satisfaction. Outcomes will be compared to other groups for which this outcome data is available.