Chapter 4 provides the reader with the results of the feedback from your evaluation tool. Describing the perspective and quotes from your reviewers will be important. You may compare and contrast the feedback findings for your project – keep in mind that you may not always agree with the feedback you have received. In this section, based on the comments and feedback from reviewers, you will make recommendations and potential changes which could be implemented to improve your project. You should add ideas on how to further disseminate your project (creating a DNP Project based on it, poster or podium presentations, inservices, etc.) This is not a chapter where you should be discussing other people’s published work except to say that the feedback from reviewers generally confirmed or were incongruent with previous published work. This chapter is usually 6-8 pages in length. Content should be separated with APA first and second level headings as appropriate.

Discussion of Findings
Feedback analysis, limitations of project approach, and conclusions drawn should be included. Discuss any concerns associated with the number of participants or reviewers.  Share what your reviewers/participants said in the evaluation tool. Share actual quotes and how you organized the material. What conclusion can you draw from the feedback? Did it confirm or contradict research found in your literature review?

Recommendations
What are you going to do in the future with this project? Now that you finished the project, what are you going to do with this information and/or project?

Assignment Expectations

Length: 1500- 2000 words;

Structure: Include a title page and reference page in APA style. These do not count towards the minimum word count for this assignment.

References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions.

Maternal Mental Health

Maternal Mental Health Disorder impacts mothers globally. One in three women experience birth trauma associated with the type of delivery or medical interventions

One in five women face maternal mental disorders and can affect the entire family

(O’Connell, 2019; Reed et al., 2017; Rees et al., 2019; Sukinik, 2018)

Purpose of the Project
To identify women who experienced trauma during childbirth and work with them to cope effectively
Data collection will guide the practice of Providers in this setting to eliminate factors that can contribute to these outcomes
(Improving Maternal Mental Health Care, 2020; McKinney et al., 2018)

Target Population

Postpartum patients

This Photo by Unknown Author is licensed under CC BY-SA
(Tappen, 2016)

Procedure Used to Gather Information
Patient interview will be performed via in person or telephone

This Photo by Unknown Author is licensed under CC BY-SA

This Photo by Unknown Author is licensed under CC BY-NC-ND
(Tappen, 2016)

Questionnaire

Tell me about your birth experience
Was it how you expected
What went well
What could we have done differently
This Photo by Unknown Author is licensed under CC BY-SA-NC
(Reed et al., 2017; Rees et al., 2019; Sukinik, 2018)

Tool used for data collection
5

Tell Me About Your Birth Experience

Having the patient talk about their birth experience can help make the patient understand what happened during their childbirth. The delivery note was reviewed before the interview on EHR, which was vital so that we could answer any possible questions the patients may have. Providing the opportunity to talk about their memories, thoughts, feelings, and birth experience are vital in a childbirth recovery process.
6

Total

Difficult Excellent Expected Good Satisfactory Unexpected 3 4 1 5 1 3
Was it How You Expected?
(Reed et al., 2017; Rees et al., 2019; Sukinik, 2018)

Most of the patients did not expect what their birth experience would be like, as some came in to induce labor, and some went into labor sooner than the expected due date.
7

Total
No Yes 14 3
What Went Well?

When asked about their birth experience and focused on what went well, Teamwork was one of our highest points of what went well in the unit. This is vital to promote safety in the team; partnership is vital to promote patient safety. Patients felt that they were cared for during their childbirth experience.
8

Total
Care experience Communication No Comment Teamwork 5 2 1 9
What Could We Have Done Differently
(Reed et al., 2017; Rees et al., 2019; Sukinik, 2018)

Most patients stated that they would not change anything, even though they did not expect their childbirth experience to go as they would think it would have gone. Things that we could have done differently are communication, care experience, Courtesy and Respect, and customer service, which could be improved.
9

Total

Care Expereince Communication Courtesy and Respect Customer Service None 1 1 1 2 12

Summary
Trauma can have a negative impact on the mother-baby dyad
Early screening is essential in maintaining the mother’s wellbeing
Debriefing after birth is a critical piece to assist closure on their unexpected birth experiences
No matter how their birth played out, debriefing with the mother and the team is vital to provide the opportunity to talk about their memories, thoughts, feelings, and birth experience
(McKinney et al., 2018; Reed et al., 2017; Simpson & Catling, 2016)

10

Project Findings or Value of Project Finding
This project is generalizable to other locations and populations
(McKinney et al., 2018; Improving Maternal Mental Health Care, 2020)

References
Improving maternal mental health care. (2020, March 2). California Health Care Foundation. Retrieved September 4, 2020, from https://www.chcf.org/project/improving-maternal-mental-health/
McKinney, J., Keyser, L., Clinton, S., & Pagliano, C. (2018). Acog committee opinion no. 736: Optimizing Postpartum Care. Obstetrics & Gynecology, 132(3), 784–785. https://doi.org/10.1097/aog.0000000000002849
Midwifery services – southern alameda county. (2021). Southern Alameda County. https://thrive.kaiserpermanente.org/care-near-you/northern-california/gsaa/departments/midwifery-services/
O’Connell, M. (2019). Preventing, recognising, and responding to fear of childbirth and birth trauma. BMJ, l2279. https://doi.org/10.1136/bmj.l2279
Reed, R., Sharman, R., & Inglis, C. (2017). Women’s descriptions of childbirth trauma relating to care provider actions and interactions. BMC Pregnancy and Childbirth, 17(1). https://doi.org/10.1186/s12884-016-1197-0
Rees, S., Channon, S., & Waters, C. S. (2019). The impact of maternal prenatal and postnatal anxiety on children’s emotional problems: a systematic review. European Child & Adolescent Psychiatry, 28, 257–280. https://doi.org/10.1007/s00787-018-1173-5
Simpson, M., & Catling, C. (2016). Understanding psychological traumatic birth experiences: A literature review. Women and Birth, 29(3), 203–207. https://doi.org/10.1016/j.wombi.2015.10.009
Sukinik, U. S. (2018, August 3). Debriefing after birth – birth you desire. Birth You Desire. https://birthyoudesire.com/debriefing-after-birth/
Tappen, R. A. (2016). Advanced nursing research from theory to practice (2nd ed.) [Kindle]. Jones & Bartlett Learning.

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6

Results and Recommendation

The practicum project was purposed to determine the childbirth process’s effects on expectant mothers’ mental health. The period of pregnancy and childbirth is a critical time in the life of a woman. During this time, the body undergoes a series of transformations that affect its emotional state. If the women are not cared for adequately, the process might negatively impact their emotional and psychological health. For instance, they may develop psychological disorders such as elevated anxiety levels, depression, and even psychosis

(O’Connell, 2019). Therefore, the practicum project aims to engage in investigative studies that expand the learning process by enhancing knowledge and skills on how to handle the birthing experience to reduce its impact on maternal psychological state. Subsequently, it deduces the strategies used in applying the research findings into the nursing practice (Reed et al., 2017).

Evaluation Strategies and the Target Audience

Investigative research was carried to deduce the birthing experience of different women. Various data collection strategies were utilized during the study, including surveys using face-to-face interviews and telephone interviews. Additionally, information EHR was also used during the process (Müller-Staub et al., 2016). The factual details compiled from a group of seventeen individuals showed variations in their childbirth experiences and the events’ impacts. The questions posed to the participants included what took place during the childbirth process and if it resonated with their preformed expectations. They were also asked the events that matched their expectations and those they would have preferred to have been done differently. The majority of the respondents indicated that they had satisfactory experiences. However, a few of those interviewed reported that they had traumatic experiences that impacted them negatively (Reed et al., 2017).

Significance of the Findings to the Nursing Practice

The investigations’ findings are significant because they help the professionals conceptualize the issues that lead to patients’ dissatisfaction during childbirth contributing to their developing distorted mental states (World Health Organization [WHO], 2018).  For instance, one respondent mentioned that they required the presence of family members. However, her demands were not possible because of the restrictions put in place due to the coronavirus pandemic. Seeking patients’ views on their perceptions about the care they received and the aspects that should be improved on is significant because it aids in disseminating holistic care that leaves the new mothers satisfied with the services, they receive (Schwab-Reese et al., 2016).

The investigation also highlighted the significance of collaborative engagement between the multidisciplinary team involved in the childbirth process. One of the respondents indicated a disconnect in communication between the nurses tasked with performing the process, which negatively impacted the process’s progress. An MD had to step in and deliver the baby. Inadequate communication between the multidisciplinary team in charge of maternal care interferes with the quality of care that the patients receive (Reed et al., 2017). As a result, it causes maternal stress, which is a significant cause of postnatal psychiatric conditions. Therefore, the study helps to conceptualize the significance of communicating effectively during the birthing process to provide a satisfactory maternal care experience.

The investigative study’s findings also bring to light the significance of involving various medical personnel during the childbirth process. For example, when nurses notice that the expectant mother is not progressing well during the process, they should consult individuals who are more skilled in the process, such as medical doctors or gynecologists. The professionals can enlighten them on the evidence-based procedures they can implement to make the process easier and faster. They may be asked to use an epidural to reduce their discomfort and lessen the chances of developing mental problems (WHO, 2018)Subsequently, the professionals can incorporate other medical experts who can elicit positive outcomes after the birthing process. For example, the nurses can encapsulate a psychiatrist’s services in the maternal care of the mothers who have undergone excruciating birthing experiences to reduce their mental health deteriorating because of the unpleasant experience. The professionals can counsel them and fortify their coping mechanisms (Reed et al., 2017).

The factual details compiled during the study will also help expand the scope of my nursing care experience and transform the way I handle maternal and birthing processes. The insights learned during the process will give me the courage to take a leadership role in maternal care. It can help me effectively lead the multidisciplinary team charged with caring for the expectant mothers in using best practices during the birthing process and caring for the infant after it is delivered . I will utilize servant leadership, which entails leading others by showing them how to correctly perform necessary procedures. It will include employing the insights learned from interviewing and interrogating the participants. I will also apply the theoretical underpinnings grasped from analyzing EHR and contextual texts that explore the issue of maternal mental health to ensure that the mothers under my care do not develop psychiatric conditions as a result of their birthing experiences (Rosa, 2016).

The practicum project plays an essential role in transforming the nursing practice by helping aspiring professionals deduce the nursing practice areas that need transformations to improve maternal care and reduce incidences where patients develop mental problems after the process. Some of the recommendations that will help enhance the practice and improve the mothers’ experiences during the process include proper timing of discharges after the birthing process. Providing adequate care during the postnatal period reduces the mothers’ chances of developing mental disruptions (WHO, 2018). The purpose of the period is to monitor the mothers, deduce any psychological disorders they may have, and provide necessary care (Reed et al., 2017). Subsequently, the duration can gauge the mothers’ mental health and the attachments they form with the young ones to ensure that they are functioning optimally, and the chance of their deteriorating is minimal.

Conclusion

The practicum project is significant to the nursing practice. The study conducted and its findings are essential in comprehending the interrelation between the birthing experience and maternal health. It helps detect the negative experiences that may occur during childbirth and the events that preceded or follow the process that may distort mothers’ mental health. The study’s findings are significant because they help determine the areas of nursing practice that should be transformed to increase patients’ satisfaction with the care they receive. Subsequently, they help deduce their significance in expanding the nurses’ competency in maternal care and taking a leadership role that improves the practices used in maternal care to incorporate evidence-based practices that prevent disruption of mothers’ mental health. The study also helps make recommendations of the areas that should be altered to enhance future practice.

References
Müller-Staub, M., de Graaf-Waar, H., & Paans, W. (2016). An internationally consented standard for nursing process-clinical decision support systems in electronic health records. CIN: Computers, Informatics, Nursing, 34(11), 493–502. https://doi.org/10.1097/cin.0000000000000277
O’Connell, M. (2019). Preventing, recognising, and responding to fear of childbirth and birth trauma. BMJ, l2279. https://doi.org/10.1136/bmj.l2279
Reed, R., Sharman, R., & Inglis, C. (2017). Women’s descriptions of childbirth trauma relating to care provider actions and interactions. BMC Pregnancy and Childbirth, 17(1). https://doi.org/10.1186/s12884-016-1197-0
Rosa, W. (2016). Nurses as leaders [Kindle]. A journey of privilege
Schwab-Reese, L. M., Schafer, E. J., & Ashida, S. (2016). Associations of social support and stress with postpartum maternal mental health symptoms: Main effects, moderation, and mediation. Women & Health, 57(6), 723–740. https://doi.org/10.1080/03630242.2016.1181140
World Health Organization. (2018, January 1). Who recommendations: Intrapartum care for a positive childbirth experience. WHO. https://www.who.int/publications/i/item/9789241550215

2

>Sheet

t want a c/s and I did not get one

. I am happy

:everyone worked together

yes

. i had a good experience

everything

no

none

no

nothing

0

none

good

none

no

none