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Disorder Treatment For Pregnant Women And Mothers Essay

Disorder Treatment For Pregnant Women And Mothers Essay

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The project aims to decrease maternal mortality among opioid-addicted pregnant women in antepartum, intrapartum, and postpartum by implementing a comprehensive set of services delivered in an integrated and coordinated approach. The paper outlines and discusses the implementation plan. It includes sections about the setting, project timeline, resources/budget, research methodology, evaluation process, execution, stakeholders, barriers and overcoming strategies, and feasibility. Disorder Treatment For Pregnant Women And Mothers Essay

Setting

The project will be implemented in a small community hospital. The facility serves a community with individuals with opioid use disorder (OUD).  Past hospital surveys have demonstrated an increase in maternal deaths, particularly among opioid-addicted pregnant mothers. Standard care for pregnant women at the hospital entails routine antenatal, delivery, and post-natal care for mothers and their babies. However, maternal mortality in this cohort is still high despite the clinical standards. Opioid-addicted mothers require appropriate care to prevent them and the child during the antepartum, intrapartum, and postpartum periods (Jalali et al., 2020; Rizk et al., 2019).  The community hospital needs to incorporate addiction treatment and management into care for pregnant women. The evidence-based project’s goal is to implement comprehensive care for pregnant patients with opioid addiction to improve maternal and child outcomes and reduce mortality.  The project will include pregnant women visiting the facility for antenatal care. Permission will be required to execute the intervention at the community hospital. An authorization letter will be sent to seek the management’s approval (Refer to Appendix A). The consent of the participants will be requested using an informed consent form (See Appendix B). The project will be implemented at the facility after approval. Disorder Treatment For Pregnant Women And Mothers Essay

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Timeline

The study is expected to go on for 365 days. The plan is to track the participant from pregnancy to postpartum. The prenatal period (time before delivery) will involve the following activities: identifying the addicted pregnant patient, referring the patient to the treatment center for medication protocol with suboxone or methadone, and routine prenatal care at the community facility.  Also, a care team will be established based on the patient’s needs.  The next phase of the project will be intrapartum, during labor and delivery, including a few days, post-childbirth. The participants will get delivery care and support services for pediatric care. The postpartum period will begin the time a participant is discharged from the hospital to day 365. The obstetric (OB), support, and pediatric care teams will collaborate for long-term care for the patient, including neonatal abstinence (withdrawal) syndrome (NAS) care.  Long-term care will include weekly appointments with the care team (rehab therapist, social worker, and counselor) and attendance at weekly support groups. The researcher will monitor the primary outcome (maternal mortality) quarterly (every 90 days) for 365 days after childbirth (Refer to Appendix C for the timeline).

Budget/Resource List

The evidence-based project will need financial resources and human capital for implementation. The community hospital will require financing the staff training to prepare the obstetricians, nurses, and other care teams to execute the interventions. No additional staff members will be recruited. The community hospital will require an external trainer who understands comprehensive, integrated, and coordinated care for pregnant patients with opioid use disorder (OUD). The trainer will be hired for $5500. The training materials, such as brochures and pamphlets, equipment, and facilitation charges, will amount to $6400. The hospital will provide the conference room, the projecting device for the presentation, and printing equipment.  The evidence-based project will also incur costs in monitoring and evaluation, including surveys, data analysis, and dissemination, for $10000. The interventions are estimated to cost $125000, assuming the project will have 50 participants at $2500. Unquantified costs related to this project are staff time as the intervention will be long-term (365 days). The availability and efficient use of the prepared budget and resources will ensure the project’s success (Refer to Appendix D). Disorder Treatment For Pregnant Women And Mothers Essay

Research Methodology for Evaluating Project Effectiveness

The evidence-based project will apply a qualitative model to determine effectiveness of the comprehensive care for pregnant women with opioid addiction.  Qualitative research involves studying project outcomes based on the participants’ perspectives. It provides a deeper understanding of the impact of the intervention. Unlike quantitative research, where the questions are structured, qualitative analysis has open-ended questions to obtain the finest details from specific patients. The data collected is analyzed using thematic content analysis. An inductive analysis of the data will be performed to identify themes, patterns, and cues related to the evidence-based practice question (Bingham, 2023).   The proposed project’s primary outcome is maternal mortality as expressed in the PICOT question: “In pregnant women who are opioid addicted, do providing a comprehensive set of services delivered in a coordinated and integrated approach compared to opioid-addicted pregnant women receiving standard care, lead to a decrease in maternal deaths in ante/intrapartum/ and postpartum patients from day 43-365 days?” However, the researcher would also want to understand the effect of comprehensive care on maternal and child outcomes. They would also like to understand the staff’s perception of the intervention. A qualitative analysis will be conducted involving the participants (opioid-addicted mothers) and the healthcare providers.

Data Collection Methods

The researcher will utilize a semi-structured questionnaire that they prepared to evaluate the project’s implementation and outcomes. The questionnaire forms will contain open-ended questions and closed questions. The closed question will gather data on demographics, maternal mortality rates, number of patients who participated and completed the intervention, dropout rate, NAS cases, and other outcomes the researcher will determine. The open-ended questions will examine medication adherence, program engagement, and the patient’s overall perceptions of the project. There will also be a section for healthcare providers to rate the comprehensive care package against standard care (Refer to Appendix E for an excerpt of the prepared research instrument).

Intervention Delivery

The intervention will be delivered in three phases. Pregnant women on prenatal care at the community hospital will be screened for opioid use disorder. The identified addicted patients will be referred to the addiction treatment center within the hospital for medication initiation and behavioral counseling. The patients will be put on methadone/suboxone to control opioid addiction. A care team will also be formed based on patient needs. During intrapartum (labor, delivery, and immediate postpartum days), the care team will provide required support services to the patients, including pediatric care.  During the postpartum phase (from discharge day to day 365) the patients will enjoy long-term care and maintenance. It will comprise having weekly appointments with their established care teams and attending peer support groups. The care teams will include a rehab therapist, a social worker, and a behavioral counselor. Literature supports comprehensive care for women with OUD to ensure holistic well-being (Jalali et al., 2020). The staff will be trained on OUD and NAS care to improve outcomes. The intervention is expected to control opioid addiction, improve maternal and child health, and decrease maternal mortality. Disorder Treatment For Pregnant Women And Mothers Essay

Stakeholders

Implementing the plan outlined herein will require the collaboration of multiple stakeholders. They include the OUD pregnant patients, healthcare providers, mental health counselors, social workers, and legal/law enforcement. The OUD pregnant women are the individuals at risk of death due to the use of opioids during pregnancy. Healthcare providers are mandated to ensure positive maternal and child health outcomes. Opioid addiction may impede proper care for pregnant mothers. It can also increase mortality risk. Mental health counselors and social workers are other leading stakeholders. The two groups help address the mental health and socioeconomic needs of the patients. Law/legal enforcement agencies are also concerned about illegal/illicit drug abuse. The project team will include obstetricians, physicians, nurses, social workers,  mental health counselors, and rehab therapists. The healthcare team will implement the outlined activities in the three project phases. The social worker and the rehab therapists/counselors will assist in long-term maintenance. The stakeholders will work together to ensure the project’s effectiveness.

Potential Barriers and Solutions

A few barriers to implementing comprehensive care for decreasing mortality in opioid-addicted pregnant women can be identified. The first barrier is the decline to participate due to concerns about legal enforcement. Normally, individuals with substance use disorder (SUD) fear revealing their drug use behavior fearing being apprehended by legal agencies. The researcher will assure the patients of anonymity and ensure the information is only utilized for study purposes and to promote individual health. Another barrier to this study would be finances (Choi et al., 2023). The community hospital may not have adequate resources to care for the recruited patients over a long period (365 years). The researcher will assist the management in applying for state funds allocated for opioid control programs.  The length of the study is another challenge. There could be a high dropout rate by the 365th day of the project. The researcher will follow up on the recruited participants to ensure adherence (Substance Abuse and Mental Health Services Administration, 2023).  The interventions outlined will address the barriers to ensure the project’s sustainability. Disorder Treatment For Pregnant Women And Mothers Essay

Plan Feasibility

            The proposed evidence-based intervention to decrease maternal deaths in pregnant women with opioid addiction is feasible. The estimated project costs amount to $146900.  The expenses cover staff training, provision of care to the recruited participants, and monitoring and evaluation. The community hospital will incur this cost to achieve decreased maternal mortality in this cohort. Increased maternal mortality rates are categorized as preventable sentinel events, which attract hefty reimbursement losses under government-sponsored health plans (Medicare and Medicaid) (Rizk et al., 2019). Implementing the plan will enhance the hospital’s financial performance due to improved quality care incentives.

Conclusion

               The implementation of comprehensive care for opioid-addicted pregnant women would improve their general well-being and decrease mortality. The project will be executed in a community hospital that has an addiction treatment center. It will involve patient screening, and antenatal, intrapartum, and postpartum care tailored to opioid addiction patients.  The project will last 365 days, with quarterly evaluations to determine effectiveness. It will be executed through the collaboration of key stakeholders, including opioid-addicted mothers, healthcare providers, social workers, and behavioral health therapists. The researcher will collaborate with the community hospital’s board to manage barriers, such as financial challenges. The overall outcome would be decreased maternal deaths in the intervention group. Disorder Treatment For Pregnant Women And Mothers Essay

              References

Bingham, A. J. (2023). From data management to actionable findings: A five-phase process of qualitative data analysis. International Journal of Qualitative Methods, 22, 1-11. https://doi.org/10.1177/16094069231183620.

Choi,  S., Rosenbloom, D., Stein, M., Raifman, J., & Clark, J. (2023). Differential gateways, facilitators, and barriers to substance use disorder treatment for pregnant women and mothers: A scoping systematic review. Journal of Addiction Medicine, 16(3), 185-196. https://doi.org/10.1097/ADM.0000000000000909.

Jalali, M. S., Botticelli, M., Hwang, R. C., Koh, H. K., & McHugh, R. K. (2020). The opioid crisis: A contextual, social-ecological framework. Health Research Policy and Systems, 18(87), 1-9.https://doi.org/10.1186/s12961-020-00596-8.

Rizk, A. H., Simonsen, S. E., Roberts, L., Taylor-Swanson, L., Lemoine, J. B., & Smid, M. (2019). Maternity care for pregnant women with opioid use disorder: A review. Journal of Midwifery and Women’s Health, 64(5), 532-544. https://doi.org/10.1111/jmwh.13019.

Substance Abuse and Mental Health Services Administration (2023). Evidence-based, whole-person care for pregnant people who have opioid use disorder. Substance Abuse and Mental Health Services Administration Advisory. https://store.samhsa.gov/sites/default/files/pep23-02-01-002.pdf. Disorder Treatment For Pregnant Women And Mothers Essay

 

Appendices

Appendix A: Site Authorization Letter

Organization Letterhead

Company Name

Address

Site Contact

Date

 

Office of Academic Research

Grand Canyon University

College of Doctoral Studies

3300 W. Camelback Road

Phoenix, AZ  85017

Phone:  602-639-7804

 

Dear IRB Members,

 

After reviewing the proposed project—————-presented by ———————-I have granted authorization for ——————————–to conduct research at our ———————————————————————————————

 

I understand the purpose of the project is to implement a comprehensive set of services, including assessment for opioid use disorder, brief intervention and referral, and postnatal addiction treatment for the mothers and neonates, to reduce maternal mortality in opioid-addicted pregnant mothers at the community hospital. Disorder Treatment For Pregnant Women And Mothers Essay

I have indicated to Researcher Name that ——————————————————-will allow the following research activities: data collection and document access. We will cooperate with the researcher in project implementation, monitoring, and evaluation.

The participants of the study should meet the following criteria:

  • Be a pregnant woman
  • Be currently seeking antenatal care at the facility

To ensure that the patients are protected, the Researcher has agreed to provide a copy of the informed consent form and recruitment methods before recruiting participants at the community hospital. I understand details that might identify the organization will not be published, and the researcher will take necessary measures to ensure data security. Researcher Name has agreed to provide a copy of the project outcomes to the hospital Disorder Treatment For Pregnant Women And Mothers Essay

 

 

Appendix B: Informed Consent

Informed Consent

Title of Study

Determining the impact of comprehensive care on maternal mortality in opioid-addicted pregnant women in antepartum, intrapartum, and postpartum compared with standard care.

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Purpose of Study

You are requested to participate in this study. Before making a decision,  read the following information and respond as appropriate. If there is anything you do not understand, kindly consult the researcher. The project aims to implement comprehensive services for opioid-addicted pregnant women to improve maternal and child outcomes and maternal mortality rates over 365 days.

Study Procedures

            The study will include patient assessment to identify opioid-addicted pregnant patients. This will be conducted on pregnant women presenting for antenatal care. Patients with OUD will be referred to the addiction treatment center to begin medication protocol with methadone/suboxone. A care team will also be established to handle the intrapartum (before and during childbirth). Support services will also be convened for the newborn. The postpartum period (hospital discharge day to day 365) will involve long-term and maintenance care.  The long-term care will include weekly appointments with the care team, including a rehab therapist, social worker, and counselor. The participants will also be encouraged to attend weekly support groups. The researcher will also monitor the participants for mortality and other outcomes. Disorder Treatment For Pregnant Women And Mothers Essay

Risks

            Personal information may leak during the study period. The researcher will take measures to secure data, such as using codes to conceal the participants’ identities. Participants will also be allowed to request deletion of their information if they drop out of the intervention.

Benefits

Participating in the study will help opioid-addicted pregnant women manage their addiction and maintain health at no cost. The community will use the results to support further implementation of comprehensive care.

Confidentiality

The researcher will ensure anonymity. They will not include any identification details. Codes will be assigned to the participant’s personal information. The researcher will also store the data in encrypted formats.

Contact Information

Kindly contact the researcher any time you feel concerned about any aspect of this research using the details provided on the first page of this informed consent form.

Voluntary Participation

Participating in this project is voluntary. If you decide to participate in the study, you will be required to sign the consent form. You can withdraw from the study at any period after signing the form.  Withdrawing from the project will not affect your relationship with the researcher or the community hospital.

Consent

I have read and understood the information herein, and I have made inquiries. I understand my participation is voluntary, and I can withdraw when I want without explaining or incurring costs.  I voluntarily decided to participate in the study. Disorder Treatment For Pregnant Women And Mothers EssaY

 

Appendix C:  Project Timeline

Project Activities Timeline (in days or weeks)
Staff Training on OUD patient care and NAS care 2 weeks before the project implementation
Prenatal Period: Opioid addiction assessment; care plan with relevant team based on patient needs and initiation of care for the identified addicted pregnant patients. From enrollment day to delivery day
Intrapartum Period:  (During labor, delivery, and a few days after delivery). From the labor onset to discharge the day after delivery
Postpartum Period: (Discharge day to the 365th day)

Care teams collaborate for long-term care and maintenance, including weekly appointments and attendance at peer support groups. Disorder Treatment For Pregnant Women And Mothers Essay

 

From discharge day to the 365th day
Evaluation, data analysis, and reporting Quarterly evaluation every 90 days from discharge day. Researchers evaluated the mortality rates among the addicted pregnant patients who participated in the study over 365 days.  Analyze and report data after every quarterly evaluation and at the end of the project.

 

Appendix D: Budget/ Resource List

Particulars/ Activities Cost in US $
External staff trainer $5500
Staff training materials and facilitation (printed brochures, pamphlets, presentations, rooms, and refreshments).

 

$6400
Interventions-Prenatal care, intrapartum, and postpartum care The estimated cost of treating one patient is $2500. If 50 patients participate in the study, the cost will be $125000
Monitoring and evaluation study- (data  collection,  analysis, report writing, and dissemination) $10000 (ongoing cost- evaluation to be done quarterly for continued quality improvement)
Personnel- obstetricians, nurses,  pediatricians, and ancillary staff-social workers/support No new staff needs to be hired
Total Estimated Cost $146900 Disorder Treatment For Pregnant Women And Mothers Essay

 

Appendix E: An Excerpt of the Study Questionnaire

The research questionnaire aims to determine the effectiveness of comprehensive care for opioid-addicted pregnant women to improve clinical outcomes and mortality rates in antepartum, intrapartum, and postpartum patients compared with standard care. The participants were to fill out the questionnaire as required. NB: Kindly do not include personal details other than the requested information.

Section A: Demographics

 

Responses
1.      Age

 

 

—– age in years

2.      Marital status Single☐

Married☐

Divorced☐

In a relationship/domestic partnership ☐

3.      Level of Education

 

Elementary☐

High School Diploma☐ Disorder Treatment For Pregnant Women And Mothers Essay

Bachelor’s Degree and above☐

4.      Employment status Employed☐

Self-employed☐

Unemployed☐

5.      Gestation age at the time of enrollment

 

—- weeks
6.      Does a patient have an OUD? Confirm through screening Yes☐

No ☐

7.      Types of drugs abused Enter as appropriate
Section B: Patients Responses
1.      How has the intervention affected your opioid addiction? Enter your response here
2.      What services did you receive?  
3.      Which services provided during prenatal care, labor, childbirth, and after delivery were most impactful and why?  
4.      What factors encouraged you to participate in the project?  
For Healthcare Providers  
1.      How was your experience delivering the proposed intervention? Was it better than usual care? Yes

No(Mark as appropriate)

2.      Would you propose the continuation of the intervention after the study period? Give reasons.  
3.      What improvements would you propose to refine the comprehensive care for opioid-addicted pregnant mothers?  
4.      How were your clinical skills improved during this study? Explain  

 

Appendix F: GCU’s APA Writing Checklist

Use this document as a checklist for each paper you will write throughout your GCU graduate program. Follow specific instructions indicated in the assignment and use this checklist to help ensure correct grammar and APA formatting. Refer to the APA resources available in the GCU Library and Student Success Center.

☒ APA paper template (located in the Student Success Center/Writing Center) is utilized for the correct format of the paper. APA style is applied, and the format is correct throughout.

☒  The title page is present. APA format is applied correctly. There are no errors.

☒ The introduction is present. APA format is applied correctly. There are no errors.

☒ Topic is well defined.

☒ A strong thesis statement is included in the introduction of the paper.

☒ The thesis statement is consistently threaded throughout the paper and included in the conclusion.

☒ Paragraph development: Each paragraph has an introductory statement, two or three sentences as the body of the paragraph, and a transition sentence to facilitate the flow of information. The sections of the main body are organized to reflect the main points of the author. APA format is applied correctly. There are no errors.

☒ All sources are cited. APA style and format are correctly applied and are free from error. Disorder Treatment For Pregnant Women And Mothers Essay

☒ Sources are completely and correctly documented on a References page, as appropriate to the assignment and APA style, and the format is free of error.

Scholarly Resources: Scholarly resources are written with a focus on a specific subject discipline and are usually written by an expert in the same subject field. Scholarly resources are written for an academic audience.

Examples of Scholarly Resources include Academic journals, books written by experts in a field, and formally published encyclopedias and dictionaries.

Peer-Reviewed Journals: Peer-reviewed journals are evaluated before publication by experts in the journal’s subject discipline. This process ensures that the articles published within the journal are academically rigorous and meet the required expectations of an article in that subject discipline.

Empirical Journal Article: This type of scholarly resource is a subset of scholarly articles that report the original findings of an observational or experimental research study. Common aspects found within an empirical article include literature review, methodology, results, and discussion.

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Adapted from “Evaluating Resources: Defining Scholarly Resources,” located in Research Guides in the GCU Library.

Assessment Traits
Requires Lopeswrite
Assessment Description
In 1,250-1,500 words, discuss the implementation plan for your evidence-based practice project proposal. When required, create the appropriate form, table, image, or graph to fully illustrate that aspect of the intervention plan and include them in an appendix at the end of your paper. You will use the implementation plan, including the associated documents in your appendices, in the Topic 8 assignment, during which you will synthesize the various aspects of your project into a final paper detailing your evidence-based practice project proposal. Disorder Treatment For Pregnant Women And Mothers Essay

Include the following:

Describe the setting and access to potential subjects. If there is a need for a consent or approval form, then one must be created. Include a draft of the form as an appendix at the end of your paper.
Create a timeline. Make sure the timeline is general enough that it can be implemented at any date. Based on the timeline you created, describe the amount of time needed to complete this project. Include a draft of the timeline as an appendix at the end of your paper.
Develop a budget and resource list. Consider the clinical tools or process changes that would need to take place. Based on the budget and resource list you developed: (a) describe the resources (human, fiscal, and other) or changes needed in the implementation of the solution; and (b) outline the costs for personnel, consumable supplies, equipment (if not provided by the institute), computer-related costs (librarian consultation, database access, etc.), and other costs (travel, presentation development). Include a draft of the budget and resource list as an appendix at the end of your paper.
Explain whether you would select a qualitative or quantitative design to collect data and evaluate the effectiveness of your evidence-based practice project proposal. Provide rationale to support your selection.
Describe the methods and instruments (questionnaire, scale, or test) to be used for monitoring the implementation of the proposed solution. Include the method or instrument as an appendix at the end of your paper.
Explain the process for delivering the intervention and indicate if any training will be needed.
Discuss the stakeholders that are needed to implement the plan.
Consider all of the aspects of your implementation plan and discuss potential barriers or challenges to the plan. Propose strategies for overcoming these challenges.
Establish the feasibility of the implementation plan.
Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document, located in Class Resources for an overview of the evidence-based practice project proposal assignments. Disorder Treatment For Pregnant Women And Mothers Essay

You are required to cite a minimum of five peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Complete the “APA Writing Checklist,” located in Class Resources, to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance. Disorder Treatment For Pregnant Women And Mothers Essay

 

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