Development of a OB Nurse Navigator Program in a Rural Critical Access Hospital
At a Glance
St. Croix Regional Medical Center received a 2022 Maternal and Child Health Grant for the project Development of an OB Nurse Navigator Program in a Rural Critical Access Hospital (St. Croix and surrounding counties). The project was successful in creating a comprehensive program to address patients’ prenatal and postpartum needs and provided social supports and resources for underserved families in this six-county rural area.
The Challenge
St. Croix Regional Medical Center serves patients from six counties and a variety of communities, including impoverished areas and Amish and Native American populations. In addition to widespread poverty, these counties have some of the highest instances of methamphetamine use in Wisconsin. There are also high instances of obesity and other chronic medical conditions in the prenatal population. In addition, many of the families struggle with food insecurity, stable transportation, and unstable living conditions. This creates a challenge to seamlessly deliver care across the continuum of obstetric needs.
Project Goals
This group aimed to create a comprehensive prenatal program, one that not only guides families through their entire pregnancy but also follows them into through the ‘fourth trimester,’ or first weeks of the postpartum period. To improve continuity and provide exceptional maternal child health care to underserved populations, the OB Nurse Navigator Program had four primary goals:
- Assist with patient assessment and the identification of high-risk perinatal and postpartum patient needs
- Improve communication by serving as a contact and liaison between the patient and obstetrical teams
- Provide consistent and extensive education related to pregnancy, high-risk perinatal care and postpartum and newborn care
- Maintain a comprehensive database of resources for patients include financial, psychosocial, education, emotional, transportation and cultural resources
Results
St. Croix Regional Medical Center successfully implemented the OB Nurse Navigator Program within their rural health clinic. This program established a structured system where nurse navigators met with patients at key prenatal milestones. Over 18 months, OB Nurse Navigators conducted 767 prenatal visits, 136 lactation consultations and 232 weight/bilirubin checks. Patient education feedback improved from 65 percent of participants reporting adequate information regarding prenatal testing prior to program implementation to 100 percent after the program was fully operational. This improvement reflects enhanced patient satisfaction and better prenatal care delivery. In addition, the team was able to increase breastfeeding rates from 77 percent in 2022 to 82.5 percent in 2024. This progress is attributed to enhanced education on breastfeeding, pumping and robust lactation follow-up services post-discharge. These targeted efforts have supported families in making informed decisions about infant feeding.
Lasting Impact
The OB Nurse Navigator Program has had a transformative impact on maternal and child health in their rural community. By fostering education, building connections and enhancing care pathways, the program continues to strengthen both individual and community well-being.
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