HQ004 Innovations to Improve Outcomes
Student Name
Walden University
NURS 6053 – Interprofessional Organizational and Systems Leadership
Prof. Name
Date
Identified Problem
Monitoring fetal heart tones (FHT) during labor is a critical aspect of ensuring fetal wellbeing. However, the current practice in many healthcare settings relies heavily on traditional wired fetal heart monitors. These devices limit a laboring woman’s mobility by tethering her to the equipment, restricting movement to a small area near the monitor. This restriction conflicts with best practices in childbirth, where unrestricted movement is recommended to facilitate a natural labor process.
Research shows that nearly 60% of laboring women are constrained from moving freely due to these wired systems, despite strong evidence indicating that mobility during labor supports physiological benefits and improved birth outcomes (Watson, Mills, & Lavender, 2022; Ondeck, 2019). Consequently, the dependence on wired monitoring adversely affects the labor experience and outcomes.
What are the effects of limited mobility during labor?
Restricted movement during labor is associated with several negative outcomes. It contradicts the healthy birth practices that advocate for walking, changing positions, and general movement during labor. Mobility has been shown to decrease the length of labor and improve birth outcomes by facilitating more effective uterine contractions and fetal descent.
High rates of medical interventions, including enforced immobility, correlate with elevated cesarean section rates—currently around 32% in the United States—which carry additional risks for both mother and infant (Ondeck, 2019). Therefore, limiting mobility may increase the likelihood of unnecessary interventions and complications.
Research on Mobility and Wireless Monitoring
Research Article #1: Mobility During Labor
Ondeck (2019) highlights the critical role of promoting mobility and allowing women to choose their preferred labor positions to support physiological childbirth. The article explains how walking and adopting upright positions during labor can shorten the first stage and reduce complications. Supporting mobility reduces the risk of harm and improves the overall birth experience.
Research Article #2: Telemetry and Patient Experience
Watson, Mills, and Lavender (2022) conducted a mixed-methods study evaluating telemetry, a wireless fetal heart monitoring technology, and its impact on both laboring women and healthcare providers. The study found that telemetry significantly enhances maternal mobility and allows a wider range of labor positions, fostering greater autonomy and dignity. Additionally, the use of telemetry was associated with lower epidural use, suggesting a more positive labor experience.
Research Article #3: Novii Wireless Patch System
The National Institute for Health and Care Excellence (2020) reviewed the Novii Wireless Patch System, an innovative wireless maternal and fetal monitoring device. Compared to traditional wired monitors, the Novii system demonstrates superior effectiveness, particularly for patients with higher body mass index (BMI). This wireless technology reduces reliance on invasive fetal monitoring methods while improving patient comfort and monitoring accuracy.
Proposed Innovation: Wireless Electronic Fetal Monitoring
What innovation is proposed to address the problem?
To address the mobility constraints imposed by wired fetal monitoring, the introduction of wireless electronic fetal monitoring devices is proposed. Specifically, the Novii Wireless Patch System offers a promising solution by enabling greater maternal freedom of movement while ensuring reliable fetal heart tone monitoring. This device is particularly advantageous for patients with obesity or those contraindicated for internal monitoring.
How does the Novii Wireless Patch System address current challenges?
The Novii system uses flexible electrode placement, enhancing the accuracy and consistency of fetal monitoring even in patients with higher BMI. This adaptability supports women’s ability to move freely and assume comfortable labor positions, aligning with physiological birth principles. Implementing this technology requires evaluating organizational readiness, overcoming barriers, and preparing staff through proper training.
Innovation Impact
The adoption of wireless fetal monitoring technology like the Novii system is expected to increase maternal mobility during labor, allowing more natural labor positions and potentially leading to improved labor outcomes and higher patient satisfaction. Compared to standard wired monitors, the Novii system provides superior fetal heart tone tracings and reduces the need for invasive monitoring, thus improving both safety and comfort.
Innovation Application: Steps for Implementation
| Step | Description |
|---|---|
| Organizational Approval | Obtain endorsement and support from healthcare leadership and key stakeholders |
| Compatibility Assessment | Assess existing fetal monitoring equipment to ensure seamless integration with the new system |
| Procurement and Training | Purchase Novii devices and provide comprehensive training for healthcare staff |
| Quality Monitoring | Develop continuous quality improvement protocols to monitor effectiveness and user satisfaction |
| Staff Engagement | Actively involve providers and stakeholders throughout implementation to foster commitment |
Implementation Considerations
For successful integration of wireless fetal monitoring, engaging staff and stakeholders throughout the process is essential to foster ownership and promote adoption. Understanding the organization’s readiness for change, anticipating barriers, and developing strategies to address challenges proactively will support sustainable management. Ongoing evaluation through quality improvement initiatives is vital to ensure long-term success (Brach, 2017; Rangachari, 2018; van Gemert-Pijnen, 2022).
References
Brach, C. (2017, June 16). ‘Will it work here?’: Health systems need contextual evidence before adopting innovations. Health Affairs Blog. https://www.healthaffairs.org/do/10.1377/hblog20170616.060641/full/
Johnson, J. K., & Sollecito, W. A. (2020). McLaughlin & Kaluzny’s continuous quality improvement in health care (5th ed.). Jones and Bartlett.
Monson, M., Heuser, C., Einerson, B. D., Esplin, I., Snow, G., Varner, M., & Esplin, M. S. (2020). Evaluation of an external fetal electrocardiogram monitoring system: a randomized controlled trial. American Journal of Obstetrics and Gynecology, 223(2), 244.e1–244.e12. https://doi.org/10.1016/j.ajog.2020.02.012
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-pdf2285965518732997
HQ004 Innovations to Improve Outcomes
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
Rangachari, P. (2018). Innovation implementation in the context of hospital QI: Lessons learned and strategies for success. Innovation and Entrepreneurship in Health, 5, 1–14. https://doi.org/10.2147/IEH.S151040
van Gemert-Pijnen, J. L. (2022). Implementation of health technology: Directions for research and practice. Frontiers in Digital Health, 4, 1030194. https://doi.org/10.3389/fdgth.2022.1030194
Watson, K., Mills, T. A., & Lavender, T. (2022). Experiences and outcomes on the use of telemetry to monitor the fetal heart during labor: Findings from a mixed methods study. Women and Birth, 35(3), 243-e252. https://doi.org/10.1016/j.wombi.2021.06.004
HQ004 Innovations to Improve Outcomes
The 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