Evidence-Based Practice Project: Postpartum ER Visits and Solutions

This report presents an evidence-based practice project focused on reducing postpartum emergency room (ER) visits for mothers and babies within one week of discharge. The project addresses the increasing trend of such visits, which lead to higher healthcare costs and patient inconvenience. The author, a nursing student, proposes the implementation of a postpartum preparedness checklist and the provision of additional educational resources to new mothers. The rationale behind this approach is that it equips mothers with the necessary knowledge and tools to manage potential complications at home, thereby decreasing the need for ER visits. The report outlines the nursing issue, provides supporting evidence, and poses a PICO(T) question to guide the project. The project's potential impact on a Family Nurse Practitioner specialty track is also discussed, emphasizing the importance of postpartum preparedness in reducing neonatal and maternal morbidity and improving patient outcomes. The author highlights the need for stakeholder engagement, including nurse managers and senior authorities, to ensure the successful implementation of the proposed changes. The report concludes by emphasizing the role of nurses in continuously improving postpartum care through evidence-based practices, with the ultimate goal of enhancing maternal health and reducing healthcare costs.

1Running head: NURSING
Nursing
Name of student:
Name of university:
Author note:

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Overview of Selected Evidenced-based Practice Project
The role of evidence-based practice in the promotion of change with evidence within
clinical settings has been continually pointed out across the literature. Evidence-based
practice is the unremitting use of current evidence in changing the process of decision making
related to patient care to facilitate optimal quality care service delivery. Such practices
integrate the suitable evidence into nursing care for achieving better patient outcomes (Hall &
Roussel, 2016). Research is essential to be conducted in an appropriate manner for
highlighting the best evidence pertaining to the research topic. It is essential that the research
conducted is systematic and it follows a suitable framework, such as the PICO(T) format. The
selected nursing issue for the present evidence-based practice project is postpartum ER visits
for mother or baby within one week of discharge. The rationale for selecting this issue is that
recent data indicates that such ER visits have increased considerably in the recent past due to
multifaceted factors. The ultimate result is increased in healthcare costs and inconvenience
for patients.
Application to selected MSN Program Specialty Track
The MSN Program speciality track is Family Nurse Practitioner. If the selected
nursing issue is resolved through the proposed project, there would be wide implications for
advanced practice for a family nurse practitioner working within the area of Postpartum
Preparedness. Postpartum preparedness refers to the plan of care for the mother as well as the
newborn after the birth in order to reduce the chances of developing complications related to
the childbirth. It is the responsibility of a nurse working in the speciality track of Postpartum
Preparedness to ensure that optimal care is delivered overcoming the constraints of
ineffective infrastructure, the literacy rate of patients and barriers to access to skilled care
workers (August et al., 2016). With the successful implementation of the proposed program,

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is is expected that high rate of neonatal and maternal morbidity can be significantly reduced.
Following ER visits after discharge implies arising complications for the baby. Reducing
such visits would ensure that nurses would not be compelled to take the increased burden and
responsibility of such visits and eventually suffer burnout (DiCenso et al., 2014).
Nursing issue and supportive evidence regarding the issue
Similar to prenatal care, the postpartum healthcare care occurs after the childbirth and
continues until a time on an individual basis. Statistics on postpartum health-care utilization
indicates that diverse challenges are faced while delivering such care and it is not surprising
that the content and extent of postpartum health care have been extensively critiqued as
limited for effectively meeting needs (Yamashita et al., 2015). As healthcare professionals, it
is the responsibility of nurses working in this field to highlight the best evidence by which
changes can be brought about in this respect so that the arising criticism can be refuted. As
mothers strive to adapt themselves to the significant role changes and new environment,
education provided to them at different stages might not be sufficient enough for them. In
addition, a systematic approach towards postpartum care is also often lacking across hospitals
(Meira et al., 2015).
The proposed project focuses on the addition of a postpartum checklist along with
impartment of education with the use of additional resources. The checklist is to be provided
to all mothers at the time of their discharge. This would ensure that all aspects of care are
included in the care plan that addresses all the needs of the mother. Such checklists are easier
for the new mothers to follow and chalk out their duties and activities in a timely manner.
Following the checklist on a regular manner promotes self-efficiency and places the mothers
in a position to care for their child successfully. Secondly, education is to be provided to the
mothers with the help of additional resources. A comprehensive, informative guidebook is to

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be provided to the mothers that they can follow at times of need. While imparting education,
nurses must conduct one-on-one sessions as these are more effective. Resources are to be
engaging, and the use of advanced technologies such as tablets are to be used (Schmidt &
Brown, 2014).
Engaging the appropriate healthcare stakeholders is pivotal in this regard. The nurse
manager needs to exercise a leadership role in encouraging all nurses to follow the change
brought about. The senior authorities are to be approached and explained the wider
advantages of the proposed change. The cost-benefit analysis is to be undertaken before the
implementation fo the plan. Conducting sessions with the stakeholders would foster the
exchange of insights and viewpoints (DiCenso et al., 2014).
The ultimate outcome of the project is reduced ER visits by new mothers for concerns
related to childbirth. Such reduction would ensure that the healthcare costs related to patient
care are reduced proportionately. Nurses would not have to spend additional time and energy
in handling such issues that could have been addressed initially. With the use of the checklist
and enhanced education, women could be given recommendations on how to ensure good
quality care, thereby reducing their chances of visiting the hospital subsequently as they
could give such care at home at their own convenience (Hamer & Collinson, 2014).
Evidence-based practice question
Outlining an evidence-based practice question is primitive for the directing the
complete evidence based proposed project. The PICO (T) question that reflects the area of
interest for the proposed project is, “In postpartum patients, will including a postpartum
preparedness checklist and providing additional resources compared to the minimal education
included in an early discharge, decrease postpartum ER visits for mother or baby within one
week of discharge”.

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Conclusion
As a healthcare professional, a nurse working in postpartum care department is to be
in a pivotal position and engage herself in continua improvement of practices. Policies and
practices can be changed, rather improved, if evidence is considered to be made the base. The
proposed evidence program is likely to decrease the incidences of postpartum ER visits for
mother or baby within one week of discharge. The change reflects the connotation of
postpartum maternal health and suggests recommendations for further change in practice for
an all-inclusive approach to the care of women after childbirth.

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References
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Hall, H. R., & Roussel, L. A. (2016). Evidence-based practice. Jones & Bartlett Publishers.
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