Capstone Log Frame And Dissemination Strategy

Capstone Log Frame And Dissemination Strategy

Capstone Logframe and Dissemination Strategy

The capstone project is about emergency preparedness in the labor and delivery unit. The setting is a developing country in Africa known as Sierra Leone which is one of the poorest countries on the continent. The capstone project is therefore carried out in a resource limited setting. Being a poor third world country, maternal mortality in Sierra Leone is one of the highest in the world at 510 maternal deaths per every 100,000 live births (Carson-Marsh et al., 2022). This project looks at the strategies that can be employed in this country’s situation to reduce maternal and fetal mortality in the peripartum period. The best way to do this would be to streamline the operations of and prepare for emergencies in the labor and delivery units of the hospitals in the country Capstone Log Frame And Dissemination Strategy.

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Preventive Strategies Informing the Quality Improvement (QI) Change

The measures that the capstone initiative is concentrating on to bring about this reality of emergency preparedness focus on reducing the rates of three of the biggest concerns. These are namely sepsis, eclampsia, and postpartum hemorrhage. Taking into consideration the limitation on resources the strategies or measures are:

Proper and accurate risk assessment on potential emergencies in the labor and delivery unit
Setting up of warning systems

Conducting emergency drills at predetermined intervals (Ameh et al.,2019)

Debriefing labor and delivery unit staff after actual incidents. This allows for the identification of strengths and the determination of areas that require improvement
Making sure the most basic emergency supplies are available in an emergency trolley within the unit
Formulating and disseminating to all staff the standard operating procedures (SOPs) or protocols to be followed in emergencies

Selection of a rapid response team, and
Identifying transformational team leaders who have the capacity to lead and motivate/ empower others to perform during emergencies

Timeline

The project timeline envisaged and set aside is a period of six months during which all the objectives should have been met. The project manager will lead the initiative and ensure that the project is completed within time and within the allocated budget. The six months will be divided according to the different phases of the project that will have to be completed in a certain amount of time.

Work Plan and Work Flow

This is where the project manager (who is a midwife and a nurse leader in the labor and delivery unit and hence conversant with its operations) will allocate resources to each phase, designate tasks to team members, set deadlines, and put in place contingency measures for risk management amongst other responsibilities (Sipes, 2020). Also, the project manager comes up with the workflows at this stage of planning in consultation with the other team members Capstone Log Frame And Dissemination Strategy.

Expected Outcomes and Impact Measurement or Evaluation

The expected outcomes of this project are a reduction in the rates of:

Postpartum hemorrhage
Postpartum sepsis, and
Eclampsia

Measurement of the above rates against the baseline rates at the end of the project will serve as the evaluation method for measuring impact and success or failure of the effort.

Dissemination

Dissemination of the recommendations drawn from this project will be done by way of podium presentations, professional journal publications, and policy briefs (Arcury et al., 2017; Brownson et al., 2018).

Logframe

Activities	Inputs: Staff, Stuff, Space	Risks/Assumptions
Training on implementing skills and drills on Emergency obstetric care	Midwifes, midwifes mentors, obstetricians, nurses, community health workers,	Obstetric emergencies can be very serious and can lead to both short- and long-term complications for the mother and baby. In addition, obstetric emergencies can lead to serious injuries for both the mother and baby.
Establishment of emergency checklists/ emergency cabinet	Training material, emergency supplies, time, IPC supplies, medical supplies, emergency protocols, communication tool, emergency trolley checklists, patients’ files
training on use of emergency checklist	training hall, skills laboratory and training equipment Capstone Log Frame And Dissemination Strategy,	implementing skills and drills on Emergency obstetric care (EmOC) training is significant in helping reduce maternal deaths
	Midwifes, midwifes mentors, obstetricians, Patient register, checklists and a hall.	Staff are always willing to acquire new knowledge and skill
Debrief staff after actual events to identify strengths and improvement opportunities		Emergency preparedness will lead to reduction of eclampsia, hemorrhage and sepsis
Auditing the emergency cases by the time the emergency was noted to end, the use of protocol, and the situation outcome.
Training on common obstetrical emergencies. Conduct morbidity/ mortality case reviews

References

Ameh, C.A., Mdegela, M., White, S., & Van den Broek, N. (2019). The effectiveness of training in emergency obstetric care: A systematic literature review. Health policy and planning, 34(4), 257-270. https://doi.org/10.1093/heapol/czz028

Arcury, T.A., Wiggins, M.F., Brooke, C., Jensen, A., Summers, P., Mora, D.C., & Quandt, S.A. (2017). Using “policy briefs” to present scientific results of CBPR: Farmworkers in North Carolina. Progress in Community Health Partnerships, 11(2), 137147. http://dx.doi.org/10.1353/cpr.2017.0018

Brownson, R.C., Eyler, A.A., Harris, J.K., Moore, J.B., & Tabak, R.G. (2018). Getting the word out: New approaches for disseminating public health science. Journal of Public Health Management and Practice, 24(2), 102–111. https://doi.org/10.1097/PHH.0000000000000673

Carson-Marsh, R., Aimone, A., Ansumana, R., Swaray, I.B., Assalif, A., Musa, A., … & Jha, P. (2022). Child, maternal, and adult mortality in Sierra Leone: Nationally representative mortality survey 2018–2020. The Lancet Global Health, 10(1), e114-e123. https://doi.org/10.1016/S2214-109X(21)00459-9

Sipes, C. (2020). Project management for the advanced practice nurse, 2^nd ed. Springer Publishing Company.

Abstract

Obstetric emergencies in the maternity unit are almost a norm and can happen at any time. Over decades, maternal morbidity has continued to rise in Sierra Leone from complications of childbirth, intra-and-post-partum. The major obstetric emergencies are postpartum hemorrhage, eclampsia, and sepsis. With Partners In Health – Maternal Centre of Excellence (MCOE) in Sierra Leone, we expect more women and more referrals and hence the potential of having more complicated cases. It is therefore important to have measures in place to curb the menace by being prepared all the time. The first steps would be to have the unit prepare themselves by assessing potential emergencies, establishing early warning systems; Identifying team leads who have the knowledge and capacity to lead during emergencies, emergency drills, and debriefing staff after actual events to identify strengths and opportunities for improvement. A successful emergency response team would benefit greatly from having appropriate emergency supplies in the emergency trolley/crash cart, protocols on handling emergencies, and having a rapid response team that will include, constant implementation of drills and simulations Capstone Log Frame And Dissemination Strategy.

Keywords: Obstetric emergencies, maternity, labor and delivery, emergency preparedness, train

Background

Many different types of obstetric emergencies can occur during labor. Obstetric emergencies can be very serious and can lead to both short- and long-term complications for the mother and baby. In Sierra Leone, maternal morbidity is a major health concern, with a ratio of 510 deaths per 100 000 live births, and is among the highest rates in the world (Carshon-Marsh et al., 2022). According to the study, hemorrhage was the major cause of maternal mortality, followed by eclampsia and sepsis. Although our hospital has a competent nursing team and other care providers who can manage emergencies, morbidity and mortality from the emergencies are on the rise. It is unknown what continues to prevent full abatement of the poor outcomes. Thus, this capstone project seeks to intervene effectively to curb the development of obstetric emergencies and improve the outcomes of care in the labor and delivery room.

Impact Statement

The capstone project aims to provide emergency preparedness training focusing on the importance of being prepared in terms of manpower, supplies, and skills-wise. The expected outcome will be enhanced patient safety and the ability to mitigate adverse outcomes.

Project Objective

The objective of this project is to implement obstetric emergency preparedness in the labor and delivery unit and improve overall patient safety. The project will ensure that a well-prepared team is available to recognize early warning signs and activate emergency protocols promptly. If a success, the Maternity unit will adopt the project interventions at the antenatal and postnatal units.

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PROJECT DESIGN AND IMPLEMENTATION

The goal of this phase is to ensure that all patients are safe since the care provider will be prepared for any emergency that may occur.During this phase, a team of midwives and clinicians will help implement the plan. As the project manager, my roles will include overseeing the project, ensuring the availability of the allocated resources, and ensuring all goals are met. Resources needed for the project include trained personnel, appropriate equipment, constant supplies in the emergency trolley/crash cart, and protocols on handling emergencies. The project will involve the constant implementation of drills and simulations, and training for midwives. According to Pattinson et al. (2019), implementing skills and drills on Emergency obstetric care (EmOC) training is significant in helping reduce maternal deaths. During this time, the team will use checklists and patient registers to investigate different ways to improve emergency preparedness. A focus will also be placed on ensuring that all stakeholders are aware of and involved in the project. The midwives will be responsible for implementing the emergency preparedness plan in the labor and delivery room.The team will train the midwives on how to be more prepared in case of an emergency by assessing potential emergencies and establishing early warning systems. As the project manager, I will help Identify team leads who have the knowledge and capacity to lead during emergencies, emergency drills, and debriefing staff after actual events to identify strengths and opportunities for improvement. Once the project is complete, it will provide a blueprint for future projects that aim to increase emergency preparedness in the labor and delivery room.

Expected Results

By December 2022, we hope to see always stocked emergency trolleys, protocols on emergency preparedness, and knowledgeable nurses and midwives. This will be measured by auditing the emergency cases by the time the emergency was noted to end, the use of protocol, and the situation outcome.

Work plan

The work plan outlines the project plan, resource management plan, and steps necessary to complete a project (Sipes, 2020). By establishing specific deadlines and outlining the tasks required to achieve them, the PM can ensure that the project proceeds in an orderly and effective manner. For this project, the project manager will conduct a training and mentorship program for the unit staff on triggers of emergencies proper monitoring of patients, and preparedness from May to July 2022. Next, the project manager will audit all emergency cases with the team involved and evaluate what was done right and what could improve to adjust and learn. Another task will be the performance of emergency drills to see if the team is well equipped in terms of skills and resources.

Estimated Timeline

The timeline for the project is six months within which the project is expected to be completed. At this time, the project manager will schedule each project phase to fit into estimated timeframes.

References

Ameh, C. A., Mdegela, M., White, S., & van den Broek, N. (2019). The effectiveness of training in emergency obstetric care: a systematic literature review. Health policy and planning, 34(4), 257-270. https://doi.org/10.1093/heapol/czz028

Carson-Marsh, R., Aimone, A., Ansumana, R., Swaray, I. B., Assalif, A., Musa, A., … & Jha, P. (2022). Child, maternal, and adult mortality in Sierra Leone: nationally representative mortality survey 2018–20. The Lancet Global Health, 10(1), e114-e123. https://doi.org/10.1016/S2214-109X(21)00459-9

Collier, A. Y., & Molina, R. L. (2019). Maternal Mortality in the United States: Updates on Trends, Causes, and Solutions. NeoReviews, 20(10), e561–e574. https://doi.org/10.1542/neo.20-10-e561

Pattinson, R. C., Bergh, A. M., Ameh, C., Makin, J., Pillay, Y., Van den Broek, N., & Moodley, J. (2019). Reducing maternal deaths by skills-and-drills training in managing obstetric emergencies: A before-and-after observational study. South African Medical Journal, 109(4), 241-245. http://dx.doi.org/10.7196/samj.2019.vl09i4.13578

Sipes, C. (2020). Project Management For the Advanced Practice Nurse (2nd Ed.). Springer

improved overall patient safety

improved maternal and newborn outcomes

well-prepared team to recognize early warning signs and activate emergency protocols promptly Capstone Log Frame And Dissemination Strategy