Date of Award

Spring 5-16-2015

Degree Type

Final Project

Degree Name

DNP Doctor of Nursing Practice

Department

Nursing

Advisor

Mary Ellen Roberts, DNP

Committee Member

Jane Dellert, Ph.D

Committee Member

Meghan Leigh, M.S.

Abstract

Purpose: A population at great risk is pregnant homeless adolescents and young adult women. Research shows that about 20% of homeless young women become pregnant (Bender, & Thompson, 2007). These pregnant young women are at an increased risk for low birth weight infants and a high infant mortality due to inadequate health care, poor dietary habits, and a knowledge deficit related to maintaining good health during pregnancy and to care of the infant and growing child. A transitional shelter may offer many psychosocial services to assist the women in becoming independent; however, a significant gap exists regarding the medical care of this population. The purpose of this DNP Project was to develop an educational program in a transitional homeless shelter focused on the health care of the pregnant woman and the newborn infant in order to bring awareness of the special needs of this high risk population and to attempt to change unhealthy behaviors. This program was coupled with an In- Service Program for staff members related to Best Practices for the Mother- Infant Dyad.

Significance of the project: Knowledge can be empowering and save lives. Through months of interaction and time spent with new mothers in a transitional shelter, the enormous lack of evidence based practices in regards to infant and child care has become evident. This vulnerable population has the highest rate of infant mortality. Education can improve the health outcomes of these women and children. These mothers are eager to learn and want to give their children a chance for a healthy life. They are lacking the information to do so.

Methods: The project was implemented in a transitional homeless shelter for women ages 18 to 23 based on a needs assessment. The project implementation contained two parts. Informal education sessions took place with pregnant women and women having recently given birth. There were both individual and group sessions. The topics included labor and delivery preparation, diet during pregnancy, care of the newborn, and safety issues related to sleep and feedings. As the infants have grown over the months the sessions have evolved to meet the needs of the growing infant and child. The second part of the project contains a series of learning modules comprising of four hours of narrated lectures and power point presentations developed for the staff.

Project Outcomes: The project initiatives were received by all involved wholeheartedly. The project brought to the shelter directors and staff members a new awareness of the crucial need for evidenced based practice in the care of the newborn and mother. Clinical observations have shown a readiness for several of the mothers to follow lessons learned. Significant changes in behaviors related to care of the infant have been observed. A level of trust has developed between the educator and the residents of the shelter. The educator has assumed the role of advocate and mentor.

Clinical Relevance: Women head up 90 percent of the families that use shelters. A third of the homeless are women and children, and the numbers are exploding. Through education, advocacy and developing a means of quality health care the lives of these women and children will be made better and healthier. A best practice model for care of the pregnant homeless women and her infant is needed.