Single Room Maternity Care: The Nursing Response, Capstone Project Example

Resolution of Nursing Satisfaction Concern

Implementation of a solution to any problem should be done after adequate consultation with the relevant stakeholders. The continued roll-out of the single room maternity care (SRMC) model in hospitals today requires input from the clients, their families, and the health personnel involved in the provision of care. This approach ensures that the SRMC model receives support from all stakeholders as it is adopted in a hospital. Satisfaction of nurses is paramount to the success of the SRMC since the nurses will serve the clients and their families better. Research studies conducted on measurement of satisfaction show that nurses in the SRMC model are satisfied by the training received to improve competency, the autonomy of the decisions made, inclusion of family in the care, and the ease with which the work (Reime, Dennis, & Janssen, 2006). When these aspects of nurses’ satisfaction are addressed, the quality of maternity care in the single rooms is improved.

Environment for Nurses’ Satisfaction

The physical setting of the single rooms should ease handling of equipment and the movement of the serving nurses, while the clients and their families should feel comfortable. Since all stages of the birthing process take place in the same room, adequate lighting should be provided using favorable lighting elements. Lighting equipment that emits harmful light waves that could affect the health of the mother and newborn babies should be avoided. The storage locations for the equipment should be appropriately designed to allow easy access of the equipment before and after use. Increased accessibility eases the work of the nurses thereby reducing fatigue during service. The single rooms should offer comfortable beds for the clients during the birthing process and provide comfort measures for dealing with discomfort and pain of the process. Such measures will aid the nurses to effectively deal with complains of the clients thereby easing the care service.

Studies have revealed that majority of SRMC nurses prefer lack of hierarchy in the model, isolation of the SRMC units, and working in small numbers (Harris, et al., 2004). These findings should be considered by the hospitals as they continue expanding their SRMC facilities. Lack of hierarchy in the model enhances consultation and communication among the SRMC personnel resulting in better decision making in the procedures involved. Isolation of SRMC units allows for better concentration of the health personnel with the absence of distractions. The isolation also enhances privacy for the clients allowing more comfort in receiving the maternity care. Nurses prefer working in small numbers in the single rooms to enhance effectiveness through work delegation and increased accountability of their responsibilities. Autonomy of nurses’ decisions in the single rooms should be respected in order to increase accountability for actions taken in the provision of maternity care. Giving directives to trained and qualified nurses on what should be done in the single rooms undermines their qualification and affects their confidence in making decisions. Obstetricians and others health personnel working in the SRMC model should allow nurses to make individual decisions regarding their responsibility in maternity care.

Training and Rewarding

Training of SRMC nurses enhances satisfaction in their service through boosting of confidence in their skills and competency (Janssen, et al., 2001). Educational needs of SRMC nurses should be met by comprehensive course studies that cover operation of SRMC machines and equipment, documentation skills, and skills to deal with clients and their families. The training equipment should allow for simulation of all the birthing process stages for effective learning by the nurses of what is expected in SRMC. Hospitals should offer sponsorship to their nurses to attend training conferences and workshops, in order to learn the ethics involved in SRMC and exchange ideas and experiences with other health professionals involved in SRMC. Training ensures nurses sharpen their communication skills for effective delivery of information and messages to clients and their families. The nurses are also imparted with negotiation skills which help in dealing with stubborn family members. Documentation of all the procedure details of the birthing stages allows the nurses to easily assess the medical conditions of the mother and baby. The assessment and analysis of the conditions enhances the experience and technical knowledge of the nurses enabling them handle similar occurrences effectively.

Nurses working in the SRMC model are required to gain clinical competency and experience in all aspects of childbirth (Reime, Dennis, & Janssen, 2006). This requirement means that more effort input is needed for the SRMC nurses to efficiently and effectively serve clients, compared to the nurses serving in the traditional maternity care models. The extra effort input deserves to be accompanied by better remuneration for the nurses to feel appreciated and serve wholeheartedly in the SRMC model. The best performing nurses based on clients’ satisfaction assessment should be rewarded for motivation to maintain their good service. Rewarding good performance also motivates other nurses in the model to work harder and better to achieve the honorary awards.

Satisfaction through Close Relationship

Hospitals should create SRMC environments that foster good relationships between the nurses and the clients. Development of close relationship allows the client to be more open to the nurse, enabling the nurse to meet her physical, emotional, spiritual, and psychological needs accurately. Integration of family-accommodation units in SRMC helps in the provision of moral support to the clients (Lowdermilk, Perry, & Cashion, 2014). Family members help nurses in postpartum care activities such as educating the mother and feeding the infant. The family units enable easier and better communication of continuity of postpartum care to the family members. The closeness between nurses and clients’ families allows freedom of expression of the concerns and fears, which are adequately addressed by the trained nurses. SRMC nurses have expressed satisfaction in the ability to accurately meet the needs and demands of clients’ family members. Creation of awareness in the society about the SRMC model will aid in easier convincing of expectant clients and their families to utilize the model as opposed to traditional maternity care models. With knowledge equipped in clients, they will be inclined to utilize the model and the SRMC nurses will be able to serve the clients better. Easier coordination with the clients enhances the satisfaction levels of the nurses in service.

Government Involvement

The government plays an important role in the success of social services programs. Formulation, implementation, and enforcement of SRMC policies will guide the operations and procedures in the model (Lowdermilk, Perry, & Cashion, 2014). The government should offer tax incentives for manufacturers of integrated equipment of the SRMC model. These incentives will lower the cost of the equipment allowing more health care centres to expand their SRMC facilities. The manufacturers should encourage hospitals to acquire more equipment through promotions and offers. The equipment supplied to hospitals should be easy to operate and handle to reduce nurses’ struggle in learning the operation. The government should always verify the functionality of the emergency-service equipment to prevent injury to the operating nurses and the SRMC clients. More equipment in the hospitals will also facilitate better training of the SRMC nurses since procedure demonstrations will be easier through improved equipment-to-nurse ratio.

Application of the Change Theory

Applying Kurt Lewin’s theory to implement change from the traditional maternity care models to the SRMC model would help in satisfaction of nurses in the new model. The stages of unfreezing, moving, and refreezing in the force field analysis should be effectively rolled out to avoid resistance to change (Ziegler, 2005). The unfreezing stage involves searching for a suitable method that allows abandoning of the old procedures of doing things that are unproductive. Identification of the driving forces and the restraining forces of change is done in the unfreezing stage. This stage can be implemented by increasing the driving forces that bring change or decreasing the restraining forces that resist change. Introduction of the SRMC model could use driving forces such as good reward for SRMC nurses and it could face restraining forces such as resistance by nurses and clients to accept new procedures. The moving stage involves the actualization of the change after a balance has been achieved between the driving and the restraining forces (Ziegler, 2005). The balance gives room for the driving forces to effect the change. The SRMC should be introduced after the addressing of all the positive and negative issues that arise. The unfreezing stage involves establishment of the new change as a norm and evaluation of its stability and effectiveness. The SRMC nurses and clients should frequently give feedback on the experiences in the model compared to the traditional models.

Conclusion

Satisfaction of nurses in SRMC model will be achieved through the comprehensive implementation of all the solutions discussed. Partial implementation is undesirable since it would have a negative effect on the level of satisfaction achieved. Clients and their families should facilitate satisfaction of SRMC nurses by following the medical advice and information provided. The government should ensure that SRMC policies are enforced to guarantee quality of services offered. The manufacturers and suppliers of materials and equipment used in the SRMC should ensure that their products meet international standards of quality and safety for use by the nurses and clients. Hospitals should ensure that the SRMC environment is friendly for nurses to offer care and clients and their families to be served. When all the stakeholders play their part, satisfaction of nurses in the SRMC model will be attained. Evidence has proved that SRMC model is provides more satisfaction to the stakeholders than the traditional models. Therefore, adoption of the model should be promoted in the health care system.

References

Harris, S. J., Farren, M. D., Janssen, P. A., Klein, M. C., and Lee, S. K. (2004). “Single room maternity care: Perinatal outcomes, economic costs and physician preferences”. Journal of Obstetrics and Gynaecology Canada, 26(7), 633-640.

Janssen, P. A., Harris, S. J., Soolsma, J., Klein, M. C., and Seymour, L. C. (2001). “Single room maternity care: The nursing response”. Birth, 28(3), 173-179.

Lowdermilk, D. L., Perry, S. E., & Cashion, M. C. (2014). Maternity Nursing (8^th Edition). Maryland Heights: Mosby Elsevier.

Reime, B., Dennis, C., & Janssen, P. A. (2006). “Development and Psychometric Testing of the Care in Obstetrics: Measure for Testing Satisfaction (COMFORTS) Scale”. Research in Nursing & Health, 29, 51-60.

Ziegler, S. M. (2005). Theory-Directed Nursing Practice (2^nd Edition). New York: Springer Publishing Company Incorporated.