2023 Northern BC Research and Quality Conference - Concurrent Session Information

Conference Poster

Concurrent Session E 

Date: November 8

Time: 1:00pm - 2:00pm 

Location: University of Northern BC, 6-205

Theme: Cultural Safety and Health Equity and Mental Health and Substance Use

Madison Friesen

Title: Hush Little Baby: Eat, Sleep, Console in Maternity and NICU at University Hospital of Northern BC (Prince George)

Objective: Neonatal Abstinence Syndrome is a clinical diagnosis of neurological, gastrointestinal, and musculoskeletal disturbances which results from the abrupt discontinuation (upon birth) of fetal exposure to substances.

Eat, Sleep, Console is an evidence-informed model focusing on the comfort and care of newborns exposed to substances by maximizing nonpharmacological interventions and increased family involvement in the care of the newborn [1].

Our objective is to implement Eat Sleep Console in the Maternity and Neonatal Intensive Care (NICU) units at UHNBC. This will result in: 

  • providing trauma informed, age-appropriate, and culturally safe care,
  • attachment and bonding of the newborn to their parent/caregiver,
  • responsive and consistent assessment, interventions, and care for substance exposed newborns with a decreased need for NICU admissions and pharmacological treatment of withdrawal.

Methods: Development of a Clinical Practice Standard. Education and training for nursing staff. ‘At the Elbow’ support for staff and parent/caregiver when a newborn exposed to substances is receiving care. Chart audits and database extraction to measure, evaluate and share implementation successes and identify challenges. 

Results: Implementation of the Clinical Practice Standard and Eat Sleep Console tool occurred at UHNBC in December 2022. Since implementation, we have seen a reduction in the length of stay for newborns, a decrease in the number of transfers to and length of stay in the NICU, and a reduction of morphine orders and administration for newborns.

Lessons Learned: Lessons learned is still ongoing for this work. Early lessons include:

  • at the elbow support along with additional training and education is critical in supporting nursing staff,
  • supporting birth parent-newborn togetherness in hospital is important to ongoing success for parent and newborns once discharged.\
  • non-pharmacologic care is possible to provide and is successful.

Michelle Roberge, Dr. Suzanne Campbell, and Anika Brookhart

Title: Bringing the patient voice and community-based partners into maternity service improvement

Description: Providing equitable maternity care in rural northern BC is the overarching focus of this project. While small and simple changes within a facility can often be identified through conversations of healthcare providers, this project sought out the patient voice to help identify larger gaps in access to guide change. This presentation will highlight the steps the obstetrics team at St. John Hospital, a small rural hospital in north central BC within the traditional Dakelh Peoples territories, did to identify barriers, make changes both immediate and long term to improve access to maternity care for the 7 First Nation and 3 non-First Nation communities the hospital serves. The presentation will showcase the quality improvement journey the obstetrics team at St. John Hospital has taken over the past year, as well as focus on the larger community-based project of tackling the need for local transportation for expectants mothers.

Method: A patient-focussed community-based survey, delivered using social media, was used to validate key gaps in access to care as well as identify new areas for improvement. Immediate changes were made through local funding streams, however for the larger project to address the lack of public transportation in Vanderhoof, a committee was formed of key partners within the community and region, including within the Health Authority logistics and volunteer services, Carrier Sekani Family Services, the municipality, and health care providers from St. John Hospital.

Lessons Learned:

  • Using the patient voice to validate and identify gaps in care is helpful to make smaller changes happen faster.
  • Asking for inter-disciplinary contributions encourages engagement in quality improvement.
  • Following a collaborative community-based model is key to producing change that is inclusive and equitable for all partners and patients. 

Objectives: Participants will leave the session with tips on how to increase patient engagement to better inform change; and will learn about the work happening at St. John Hospital to make access to maternity care more equitable for all patients and how that can branch into improved access for other patients (eg. oncology).