Doctor of Nursing Practice (DNP) Projects

Date of this Version

11-23-2020

Embargo Date

12-8-2020

Document Type

Project

Department

Nursing

Track

Post-Master's

Keywords

CenteringPregnancy, group prenatal care, patient satisfaction, patient experience, provider-patient satisfaction

Abstract

Background: CenteringPregnancy group prenatal care has been demonstrated to improve patient satisfaction and patient experience. (Ickovics, 2019). Patient experience is one aspect of patient satisfaction; it relates to patient perceptions of respect and involvement in decision-making that bestows a sense of agency and autonomy upon the individual.

Objective: To evaluate a newly implemented CenteringPregnancy program and compare outcomes with traditional prenatal care in the same institution, in terms of patient experience of respect, agency and autonomy.

Design: Evidence-based program evaluation, descriptive study with analysis.

Setting: Patients who had received group prenatal care or traditional prenatal care at an urban academic hospital between May 2019 and May 2020.

Patients: All patients registered in CenteringPregnancy group prenatal care were recruited. Patients who were registered for traditional prenatal care and were of similar risk status and gestation, were recruited from the same clinic during the same period.

Measurements: The author developed a survey that collected demographic data, and responses to closed-ended items from two reliable and validated surveys, the Mothers Autonomy in Decision Making (MADM) scale (Vedam, Stoll, Martin, et al., 2017a) and the Mothers on Respect (MOR) index (Vedam, Stoll, Rubaskin, et al., 2017b). Demographic data was reported by group. Surveys used Likert scales and results were scored, totaled and analyzed for each survey and each group.

Results: One hundred and six CenteringPregnancy patients were recruited and a similar number from traditional prenatal care. Sixty-nine respondents with completed survey responses were included in the program evaluation. The CenteringPregnancy group had 38 respondents and the traditional prenatal care group had 31. Pearson Chi Square tests were performed, and groups were similar in all categories: ethnicity (p = 0.834), age (p = 0.735), race (p = 0.613), parity (p = 0.076). There were no significant differences between groups for the MADM scale, (p = 0.244) or the MOR index, (p = 0.156).

Limitations: This was a program evaluation and the sample size was limited by the number of patients registered in the newly implemented program. The sample may not have represented all patients and all patient experiences being measured. Subjects were self-selected resulting in potential selection bias. Self-reporting allowed for errors in assignment to groups. The facilitators of group prenatal care may have lacked sufficient experience to conduct prenatal sessions with fidelity to the model of CenteringPregnancy care.

Conclusions: This program evaluation demonstrated that CenteringPregnancy patients experienced high levels of autonomy and respect in patient experience, similar to the traditional prenatal care group. There were no significant differences in outcomes for the MADM and MOR surveys.

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Date Posted: 25 February 2022