Reduction of Peripartum Racial and Ethnic Disparities: A Conceptual Framework and Maternal Safety Consensus Bundle

Howell, Elizabeth A.; Brown, Haywood L.; Brumley, Jessica; Bryant, Allison; Caughey, Aaron B.; Cornell, Andria; Grant, Jacqueline H.; Gregory, Kimberly D.; Gullo, Susan M.; Kozhimannil, Katy B.; Mhyre, Jill M.; Toledo, Paloma; DʼOria, Robyn; Ngoh, Martha; Grobman, William A.

doi:10.1016/j.jogn.2018.03.004

Cited by 82 publications

(99 citation statements)

References 76 publications

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“…(Baird & Graves, 2015;Bingham, 2012;Bittle, O'Rourke, & Srinivas, 2018;Geller, Cox, & Kilpatrick, 2006;Lundsberg et al, 2018). The consensus bundles recommended improving the education of clinicians (Bernstein et al, 2017;Howell et al, 2018;Main, Goffman, et al, 2015). Clinicians perceived improved safety after education, but the studies lacked evaluation of provider behavior change and the perception of safety improvements were not compared to outcomes (Chagolla, Bingham, Wilson, & Scheich, 2018;Dadiz et al, 2013).…”

Section: Resultsmentioning

confidence: 99%

“…High task loads were a mechanism leading to disparate racial and ethnic maternal outcomes. With heavier workloads, clinicians relied more on automatic reactions, which increased the likelihood of activating implicit bias (Howell et al, 2018), i.e., the unconscious tendency to utilize ethnic, racial, and cultural stereotypes in decision-making (Staats, Capatosto, Wright, & Contractor, 2015).…”

Section: Tasksmentioning

confidence: 99%

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Prevention of Failure to Rescue in Obstetric Patients: A Realist Review

Bernstein

Kelechi

Catchpole

et al. 2021

Worldviews Ev Based Nurs

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Background: At least 40% of maternal deaths are attributable to failure to rescue (FTR) events. Nurses are positioned to prevent FTR events, but there is minimal understanding of systemslevel factors affecting obstetric nurses when patients require rescue.Aims: To identify the nurse-specific contexts, mechanisms, and outcomes underlying obstetric FTR and the interventions designed to prevent these events.Methods: A realist review was conducted to meet the aims. This review included literature from 1999 to 2020 to understand the systems-level factors affecting obstetric nurses during FTR events using a human factors framework designed by the Systems Engineering Initiative for Patient Safety.Results: Existing interventions addressed the prevention of maternal death through education of clinicians, improved protocols for care and maternal transfer, and an emphasis on communication and teamwork.Linking Evidence to Action: Few researchers addressed task overload or connected employee and organizational outcomes with patient outcomes, and the physical environment was minimally considered. Future research is needed to understand how systems-level factors affect nurses during FTR events.

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Section: Resultsmentioning

confidence: 99%

Section: Tasksmentioning

confidence: 99%

Prevention of Failure to Rescue in Obstetric Patients: A Realist Review

Bernstein

Kelechi

Catchpole

et al. 2021

Worldviews Ev Based Nurs

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“…As such, for the survey+testing cohort, enrollment is phased to accommodate the enrollment of a maximum of 660 women per six-month period. We expect to enroll 660 participants in study phase 1 (study months 1-7), 660 (total enrolled = 1320) in phase II (study months 8-13), 660 (total enrolled = 1980) in phase III (study months [14][15][16][17][18][19], and 520 (total enrolled = 2500) in phase IV (study months [20][21][22][23][24]. For infants, given it is an opt-in test that involves a heel prick, we expect approximately 50% of mothers to opt in, resulting in an infant enrollment of 1250.…”

Section: Methodsmentioning

confidence: 99%

“…It is also known that some factors like social support and nutritional support from programs like the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) can help to buffer against adverse outcomes [23]. It is also critical to note that health care providers (including nurses, physicians, and others) exert an important influence over how comfortable a woman feels when seeking help and health care for pregnancy, birth, and postpartum [24].…”

Section: Background and Rationalementioning

confidence: 99%

Examining the Impact of the 2019 Novel Coronavirus and Pandemic-Related Hardship on Adverse Pregnancy and Infant Outcomes: Design and Launch of the HOPE COVID-19 Study

et al. 2020

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The 2019 novel coronavirus disease (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread and worsen in many parts of the world. As the pandemic grows, it is especially important to understand how the virus and the pandemic are affecting pregnant women and infants. While early data suggested that being infected with the virus did not increase the risk of adverse pregnancy or infant outcomes, as more information has emerged, it has become clear that risks for some adverse pregnancy and infant outcomes are increased (e.g., preterm birth, cesarean section, respiratory distress, and hospitalization). The Healthy Outcomes of Pregnancy for Everyone in the time of novel coronavirus disease-19 (HOPE COVID-19) study is a multi-year, prospective investigation designed to better understand how the SARS-CoV-2 virus and COVID-19 impact adverse pregnancy and infant outcomes. The study also examines how the pandemic exacerbates existing hardships such as social isolation, economic destabilization, job loss, housing instability, and/or family member sickness or death among minoritized and marginalized communities. Specifically, the study examines how pandemic-related hardships impact clinical outcomes and characterizes the experiences of Black, Latinx and low-income groups compared to those in other race/ethnicity and socioeconomic stratum. The study includes two nested cohorts. The survey only cohort will enroll 7500 women over a two-year period. The survey+testing cohort will enroll 2500 women over this same time period. Participants in both cohorts complete short surveys daily using a mobile phone application about COVID-19-related symptoms (e.g., fever and cough) and complete longer surveys once during each trimester and at 6–8 weeks and 6, 12 and 18 months after delivery that focus on the health and well-being of mothers and, after birth, of infants. Participants in the survey+testing cohort also have testing for SARS-CoV-2 and related antibodies during pregnancy and after birth as well as testing that looks at inflammation and for the presence of other infections like Influenza and Rhinovirus. Study results are expected to be reported on a rolling basis and will include quarterly reporting for participants and public health partners as well as more traditional scientific reporting.

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“…Creating Change for respectful care means transforming institutions and creating a new culture [31]. Centering the voices and experiences of the group most impacted by the inequity is of greatest importance.…”

Section: Creating Changementioning

confidence: 99%

The Cycle to Respectful Care: A Qualitative Approach to the Creation of an Actionable Framework to Address Maternal Outcome Disparities

Green

Perez

Walker

et al. 2021

IJERPH

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Despite persistent disparities in maternity care outcomes, there are limited resources to guide clinical practice and clinician behavior to dismantle biased practices and beliefs, structural and institutional racism, and the policies that perpetuate racism. Focus groups and interviews were held in communities in the United States identified as having higher density of Black births. Focus group and interview themes and codes illuminated Black birthing individual’s experience with labor and delivery in the hospital setting. Using an iterative process to refine and incorporate qualitative themes, we created a framework in close collaboration with birth equity stakeholders. This is an actionable, cyclical framework for training on anti-racist maternity care. The Cycle to Respectful Care acknowledges the development and perpetuation of biased healthcare delivery, while providing a solution for dismantling healthcare providers’ socialization that results in biased and discriminatory care. The Cycle to Respectful Care is an actionable tool to liberate patients, by way of their healthcare providers, from biased practices and beliefs, structural and institutional racism, and the policies that perpetuate racism.

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Reduction of Peripartum Racial and Ethnic Disparities: A Conceptual Framework and Maternal Safety Consensus Bundle

Cited by 82 publications

References 76 publications

Prevention of Failure to Rescue in Obstetric Patients: A Realist Review

Prevention of Failure to Rescue in Obstetric Patients: A Realist Review

Examining the Impact of the 2019 Novel Coronavirus and Pandemic-Related Hardship on Adverse Pregnancy and Infant Outcomes: Design and Launch of the HOPE COVID-19 Study

The Cycle to Respectful Care: A Qualitative Approach to the Creation of an Actionable Framework to Address Maternal Outcome Disparities

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