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Maternal and neonatal health outcomes following the implementation of an innovative model of nurse practitioner-led care for diabetes in pregnancy

Citation

Murfet, GO and Allen, P and Hingston, TJ, Maternal and neonatal health outcomes following the implementation of an innovative model of nurse practitioner-led care for diabetes in pregnancy, Journal of Advanced Nursing, 70, (5) pp. 1150-1163. ISSN 1365-2648 (2013) [Refereed Article]

Copyright Statement

Copyright 2013 John Wiley & Sons Ltd

DOI: doi:10.1111/jan.12277

Abstract

Aim. To investigate maternal and neonatal outcomes following implementation of a nurse practitioner-led model of care for diabetes in pregnancy. Background. Diabetes in pregnancy increases the risk of adverse health outcomes in mothers and infants. The management of diabetes in pregnancy is crucial to reduce poor outcomes. Design. Uncontrolled before-after intervention study. Methods. International Classification of Diseases codes were used to identify pregnancies suspected of being complicated by diabetes. Demographic, health, diabetes and maternity data were extracted from hospital records. Adverse maternal and neonatal outcomes were compared pre- (20032006) and postintervention (20102011). Adjusted relative risks (aRR) were calculated using the glm command in Stata. Results. A total of 261 pregnancies were included: 112 pre-intervention and 149 managed under the nurse practitioner-led model. There were 37 women with pre-existing diabetes (26 T1DM, 11 T2DM) and 195 with gestational diabetes. Referrals to dieticians and diabetes educators increased, while referrals to physicians decreased. There was no decrease in the risk of adverse maternal outcomes for all women with DIP or women with GDM. However, there was a 24% decrease in adverse neonatal outcomes overall and a 40% decrease among infants of women with gestational diabetes. Conclusion. The study demonstrated that nurse practitioner-led models of care for diabetes in pregnancy are feasible. The findings suggest that the model reduced adverse neonatal outcomes. By improving information provision, support and care coordination, the model is particularly valuable in rural areas, where access to medical specialists is often restricted.

Item Details

Item Type:Refereed Article
Keywords:Diabetes, model of care, nurse practitioner, pregnancy
Research Division:Medical and Health Sciences
Research Group:Nursing
Research Field:Clinical Nursing: Primary (Preventative)
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Diabetes
Author:Allen, P (Dr Penny Allen)
ID Code:87653
Year Published:2013
Web of Science® Times Cited:5
Deposited By:Rural Clinical School
Deposited On:2013-11-29
Last Modified:2017-11-03
Downloads:0

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