Doctor of Nursing Practice Program

• Committee Chair Name & Credentials:
  Bette Moore, PhD, RN, IBCLC, FAAN
• Committee Member Name & Credentials:
  Pam Jones, DNP, RN, NEA-BC, FAAN, and Sharon L. Holley, DNP, CNM, FACNM

DNP Project Abstract

Providing Care for Pregnant People of Size: A Nurse-Midwife's Guide to the First Prenatal Visit

Purpose
The purpose of this project was to improve the confidence, knowledge, and self-efficacy of Certified Nurse-Midwives (CNMs) when caring for pregnant people of size by creating and implementing an educational module for the first prenatal visit specific to the patient population.

Methods
The project design focused on translating evidence into practice by creating an evidence-based training module. This training updated CNMs on the latest evidence regarding initiating prenatal care for pregnant people with a BMI of 40.0 and higher. Confidence, knowledge, and self-efficacy of each participant was assessed by a pre-test before and post-test after completion of the module.

Results
Descriptive Statistics were used to assess the change in confidence, knowledge, and self-efficacy scores of the CNMs from pre- to post-test. The mean confidence score increased from 47.65 (SD=18.80) to 79.95 (SD=10.59), a 67.79% increase. The mean perceived knowledge score increased from 50.0, (SD=17.69) to 80.7, (SD=10.61) a 61.4% increase. The mean self-efficacy score increased from 56.75 (SD=18.23) to 78.9 (SD=12.51) a 39.0% increase. Results for these three outcomes were statistically significant (p< 0.05). While knowledge scores from the general knowledge quiz did increase slightly for most participants, this result was not statistically significant.

Implications for Practice
Certified Nurse-Midwives (CNMs) are experts in caring for vulnerable populations and pregnant people of size can require additional interventions in pregnancy. An educational module was created to better prepare CNMs to care for this patient population. The outcomes of this intervention included a statistically significant increase in the mean scores for confidence, perceived knowledge, and self-efficacy from pre- to post-test. The results demonstrate that these outcomes can be improved with targeted educational interventions and may positively influence patient care.