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Problem Statement: Enhanced Recovery After Surgery (ERAS) guidelines provide a multi-modal, standardized, and systematic approach to the perioperative period with the overall goal of improving patient outcomes. ERAS protocols emphasize patient engagement as an integral facet of the pathway of care, yet the ERAS literature is sparse when providing guidance to clinicians regarding how to effectively engage patients in their care.Purpose: This project introduced motivational interviewing (MI) communication approaches to inpatient perinatal nurses caring for patients undergoing an enhanced recovery pathway for cesarean birth. Knowledge of motivational interviewing approaches, nurse confidence in motivating patients to actively engage in ERAS elements of self-care, relevance of motivational interviewing to promote the nurse-patient relationship and the likelihood to incorporate motivational interviewing into patient care were evaluated. Evaluation of the promotion of respectful maternity care through MI approaches occurred. Methods: A non-experimental pretest-posttest design served as this quality improvement intervention. This project introduced motivational interviewing communication approaches via a one-hour interactive, educational presentation with a focus on promoting nurses to engage patients in the ERAS self-care elements following cesarean birth. Means and paired t-test results were analyzed for the pre- and post-presentation surveys. A two-week follow-up survey collected general nurse demographic information and evaluated the implementation of motivational interviewing approaches to ascertain whether increased nursing experience and involvement in hospital or unit-based committees and professional development would increase nurses’ likelihood to incorporate MI approaches with patients. Inclusion Criteria: Perinatal nurses caring for patients during the inpatient admission for cesarean birth undergoing an ERAS for cesarean birth pathway at an academic medical center performing approximately 4,800 births annually across the two hospital campuses. Analysis: The pre- and post-presentation results demonstrated statistically significant differences (n=18). The relationship between motivational interviewing approaches and the provision of respectful maternity care was confirmed by all nurse participants. Ninety-four percent of respondents reported the utilization of MI in the two-week follow-up surveys and, of those who utilized MI, 100% also reported they would continue to utilize motivational interviewing in their nursing practice. Implications for Practice: Results demonstrated the feasibility of MI in perinatal inpatient clinical settings. This project holds potential for significant impact for clinical care within maternal health settings where nearly 30% of individuals deliver via cesarean birth and supports the applicability of MI to other clinical perinatal patient scenarios beyond the ERAS for cesarean birth pathway. Results also demonstrates that MI communication approaches can support the delivery of respectful maternity care. The U.S. maternal health crisis demands that perinatal nurses seek solutions and actionable initiatives to improve outcomes and mitigate maternal health disparities. These findings support the implementation of motivational interviewing as an approach to enhance nurse-patient communication methods that promote patient engagement framed within a partnership of compassion and respect of patients’ autonomy and values. |
