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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

journal contribution
posted on 2023-05-17, 20:46 authored by Murfet, GO, Allen, P, Hingston, TJ
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- (2003–2006) and postintervention (2010–2011). 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.

History

Publication title

Journal of Advanced Nursing

Volume

70

Issue

5

Pagination

1150-1163

ISSN

1365-2648

Department/School

Tasmanian School of Medicine

Publisher

Wiley-Blackwell Publishing Inc.

Place of publication

United Kingdom

Rights statement

Copyright 2013 John Wiley & Sons Ltd

Repository Status

  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified

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    University Of Tasmania

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