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Kim, Park, Shin, Cho, Choi, Jun, Kim, and Ahn: Development and Evaluation of Empowering Education Program for Maternal Fetal Intensive Care Unit (MFICU) Nurses
Original Article

Korean Journal of Women Health Nursing 2019; 25(3): 345-358.

Published online: 10 September 2019

DOI: https://doi.org/10.4069/kjwhn.2019.25.3.345

Development and Evaluation of Empowering Education Program for Maternal Fetal Intensive Care Unit (MFICU) Nurses

Jeung-Im Kim1, Mikyung Park2, Gisoo Shin3, Insook Cho4, So Young Choi5, Eun-Mi Jun6, Yunmi Kim7, Sukhee Ahn8

1Professor, School of Nursing, College of Medicine, Soonchunhyang University, Cheonan, Korea.

2Professor, Department of Nursing, Nambu University, Gwangju, Korea.

3Professor, Red Cross College of Nursing, Chung-Ang University, Seoul, Korea.

4Professor, Department of Nursing, College of Medicine, Inha University, Incheon, Korea.

5Professor, College of Nursing, Institute of Health Science, Gyeongsang National University, Jinju, Korea.

6Professor, Department of Nursing, Pai Chai University, Daejeon, Korea.

7Associate Professor, College of Nursing, Gachon University, Incheon, Korea.

8Professor, College of Nursing, Chungnam National University, Daejeon, Korea.

Corresponding author: Sukhee Ahn. College of Nursing, Chungnam National University, 266 Munwha-ro, Jung-gu, Daejeon 35015, Korea. Tel: +82-42-580-8324, Fax: +82-42-580-8309, sukheeahn@cnu.ac.kr

Received 27 August 2019       Revised 2 September 2019       Accepted 3 September 2019

© 2019 Korean Society of Women Health Nursing

Korean Society of Women Health Nursing

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was conducted to develop an empowering education program for Maternal-Fetal Intensive Care Unit (MFICU) nurses who provide intensive care to high-risk mother and fetus at hospitals, to test effects of the education program on nursing care confidence and nursing knowledge, and to examine program satisfaction.

Methods

This study comprised of 2 phases: program development and evaluation. First, we have followed a process of program development to develop and refine an empowering education program for MFICU nurses through collaborative works among clinical obstetrics and gynecology doctors and nurses and academic nursing professors. Second, the empowering education program was provided to 49 nurses and evaluated from July 5 to 6, 2019. Levels of MFICU nursing care confidence and knowledge were measured.

Results

The empowering education program included 18 hours of lectures, discussion, and Q & A, which continued for 2 days. This program significantly improved high-risk maternal-fetal nursing care confidence and knowledge of nurses. The program was well met with nurses' education need and goals, and found to be highly satisfactory.

Conclusion

The empowering education program was observed to be effective in terms of improve nursing care confidence and knowledge of nurses in MFICU. It is proposed that this program should be open regularly for nurses to obtain and improve their clinical knowledge, confidence, and competency. Further study is needed to develop and run 2-levels of education such as basic and advanced levels based on nurses' clinical background and competency.

Keywords: Nurses, Education, Self confidence, Knowledge, High-risk pregnancy

Figures and Tables

Table 1

Empowering Education Program for MFICU Nurses

kjwhn-25-345-i001
Day 1
Management of high-risk pregnancy during antepartum period
Preterm labor
Preterm premature rupture of membrane and amnionitis
Gestational diabetes
Hypertensive disorder: preeclampsia and eclampsia
Incompetent internal os of cervix
Placenta previa and abruptio placenta
Medication, monitoring, and test for high-risk pregnancy
MFICU medication during perinatal period
Dystocia
Disease related to amniotic fluid: hydramnios and oligohydramnios
Fetal surveillance: Biophysical profile and fetal blood flow by doppler
Intrauterine growth restriction
Reflection & evaluation
Day 2
Management of high-risk pregnancy during intrapartum and postpartum period
Postpartum hemorrhage and hypovolemic shock
Transfusion
Septic shock
Disseminated intravascular coagulation, amniotic embolism, pulmonary embolism
Newborn cardiopulmonary resuscitation
MFICU nurses' task and case management
Nursing care for high-risk pregnant women
Advanced nursing care for high-risk pregnant women
Maternal fetal intensive care unit set up and case management
Reflection & evaluation
MFICU=Maternal-Fetal Intensive Care Unit.
Table 2

General Characteristics of Study Subjects (N=49)

kjwhn-25-345-i002
Characteristics Categories n(%) M±SD Range
Age (year) <30 16 (32.6) 35.86±8.77 22–59
30–39 14 (28.6)
≥40 19 (38.8)
Education Associate degree 35 (71.4)
Bachelor and above 14 (28.6)
Type of hospital Tertiary hospital 37 (75.5)
General hospital 11 (22.4)
Others 1 (2.1)
MFICU open Yes 38 (77.6)
No 11 (22.4)
MFICU opening year (n=38) 2014–2016 11 (28.9)
2017–2019 24 (63.2)
Don't know 3 (7.9)
Working place MFICU 30 (61.2)
Delivery room 11 (22.4)
OBGY ward 5 (10.2)
Nursery 1 (2.0)
No response 2 (4.2)
Clinical experiences (year)† General ward 22 (44.9) 6.42±4.83 0.1–17.4
Delivery room 37 (75.5) 6.57±5.36 0.2–18.0
OBGY ward 26 (53.1) 4.32±4.36 0.1–17.2
OBGY OPD 3 (6.1) 6.73±3.10 3.2–9.0
ICU 6 (12.2) 5.95±4.80 1.0–13.0
MFICU 30 (61.2) 1.66±1.15 0.1–4.0
Total 11.99±7.85 0.2–34.0
MFICU education from MFICU unit Yes 13 (26.5)
Frequency 6.3 1–12
Hours of education 8 4–16
MFICU education from conference Yes 13 (26.5)
Frequency 4.2 1–10
Hours of education 4.9 1–12
MFICU education from nursing academic society Yes 8 (16.3)
Frequency 2.4 1–12
Hours of education 6.5 4–8
MFICU education from medical academic society Yes 11 (22.4)
Frequency 2.6 1–16
Hours of education 7.5 2–16
M±SD=mean±standard deviation.
MFICU=Maternal Fetal Intensive Care Unit; OBGY=obstetrics and gynecology; OPD=outpatient department; ICU=intensive care unit.
†Multiple response.
Table 3

Comparisons of Confidence and Knowledge Before and After Education Program (N=49)

kjwhn-25-345-i003
Variables Pretest Posttest Difference t p
M±SD M±SD M±SD
Confidence 97.45±16.13 113.59±16.55 16.14±21.37 5.29 <.001
Knowledge 18.10±3.14 20.81±2.04 2.71±3.53 5.37 <.001
M±SD=mean±standard deviation.
Table 4

Differences in Confidence according to Clinical Experience at Delivery Room (N=49)

kjwhn-25-345-i004
Characteristics Category n(%) Pretest Posttest Difference
M±SD M±SD M±SD
Clinical experience at delivery room Yes 37 (75.5) 101.05±15.64 113.32±16.12 12.27±20.49
No 12 (24.5) 86.33±12.46 114.41±18.50 28.08±20.31
t (p) 2.96 (.005) −0.20 (.845) −2.37 (.024)
M±SD=mean±standard deviation.
Table 5

Program Satisfaction Survey at Day 1 and Day 2 (N=46)

kjwhn-25-345-i005
Days Difficulty of education Met education need Goal achievement Need for advanced education†
Easy Appropriate Hard No Yes No Yes Knowledge Skills Clinical Training
Day 1
1. Preterm labor 9 (19.6) 37 (80.4) - - 46 (100) 1 (2.2) 45 (97.8) 27 (64.3) 7 (16.7) 8 (19.0)
2. Preterm premature rupture of membrane, amnionitis 7 (15.2) 39 (84.8) - 2 (4.3) 44 (95.7) 1 (2.2) 45 (97.8) 30 (68.2) 8 (18.2) 6 (13.6)
3. Gestational DM 5 (10.9) 41 (89.1) - - 46 (100) - 46 (100) 30 (69.8) 7 (16.3) 6 (14)
4. Hypertensive disorder 5 (10.9) 41 (89.1) - - 46 (100) - 46 (100) 33 (75.0) 5 (11.4) 6 (13.6)
5. Incomplete internal os of cervix 6 (13.0) 40 (87.0) - 2 (4.3) 44 (95.7) 1 (2.2) 45 (97.8) 27 (62.8) 7 (16.3) 9 (20.9)
6. Placenta previa, abruptio placenta 4 (8.7) 42 (91.3) - - 46 (100) - 46 (100) 25 (58.1) 10 (23.3) 8 (18.6)
7. MFICU medication 5 (10.9) 40 (87.0) 1 (2.2) - 46 (100) - 46 (100) 29 (67.4) 7 (16.3) 7 (16.3)
8. Dystocia 4 (8.7) 40 (87.0) 2 (4.3) - 46 (100) - 46 (100) 19 (44.2) 15 (34.9) 9 (20.9)
9. Disease related to amniotic fluid 10 (21.7) 34 (73.9) 2 (4.3) 4 (8.7) 42 (91.3) 3 (6.5) 43 (93.5) 33 (73.3) 7 (15.6) 5 (11.1)
10. Fetal surveillance 3 (6.5) 39 (84.8) 4 (8.7) 2 (4.3) 44 (95.7) 3 (6.5) 43 (93.5) 26 (60.5) 10 (23.3) 7 (16.3)
11. Intrauterine growth restriction 5 (10.9) 39 (84.8) 2 (4.3) - 46 (100) - 46 (100) 32 (71.1) 6 (13.3) 7 (15.6)
Day 2
1. Postpartum hemorrhage, hypovolemic shock 3 (6.5) 38 (82.6) 5 (10.9) - 46 (100) - 46 (100) 26 (57.8) 13 (28.9) 6 (13.3)
2. Transfusion 8 (17.4) 37 (80.4) 1 (2.2) - 46 (100) 2 (4.3) 44 (95.7) 31 (73.8) 7 (16.7) 4 (9.5)
3. Septic shock 3 (6.5) 32 (69.6) 11 (23.9) 1 (2.2) 45 (97.8) 1 (2.2) 45 (97.8) 32 (74.0) 6 (14.0) 5 (11.6)
4. DIC, amniotic/pulmonary embolism 3 (6.5) 38 (82.6) 5 (10.9) - 46 (100) - 46 (100) 30 (71.4) 8 (19.0) 4 (9.5)
5. Newborn CPR 3 (6.5) 36 (78.3) 7 (15.2) 1 (2.2) 45 (97.8) - 46 (100) 12 (25.5) 27 (57.4) 8 (17.0)
6. Nursing care for high-risk pregnant women 14 (30.4) 32 (69.6) - 9 (19.6) 37 (80.4) 7 (15.2) 39 (84.8) 23 (51.1) 8 (17.8) 14 (31.1)
7. Advanced care for high-risk pregnant women 9 (19.6) 37 (80.4) - 2 (4.3) 44 (95.7) 2 (4.3) 44 (95.7) 17 (23.8) 10 (22.2) 18 (40.0)
8. MFICU set up and management 9 (19.6) 37 (80.4) - 2 (4.3) 44 (95.7) 2 (4.3) 44 (95.7) 13 (30.2) 7 (16.3) 23 (53.5)
DM=diabetes mellitus; MFICU= Maternal Fetal Intensive Care Unit; DIC=disseminated intravascular coagulation; CPR=cardiopulmonary resuscitation.
†Multiple response.

Notes

Funding This study was supported by the 2019 Policy Research Fund from Korean Society of Women's Health Nursing.

Conflict of Interest The authors declared no conflict of interest.

Author Contributions

  • Conceptualization: Kim JI, Ahn S, Kim Y.

  • Formal analysis: Kim JI, Shin, GS, Ahn S.

  • Investigation: Kim JI, Park M, Shin G, Cho I, Choi SY, Jun EM, Kim Y, Ahn S.

  • Writing - original draft: Kim JI, Shin G, Ahn S, Park M, Cho I, Choi SY, Jun EM, Kim Y.

  • Writing - review & editing: Ahn S, Kim JI, Shin G, Kim Y, Cho I, Park M.

Summary Statement

  • • What is already known about this topic?

  • With an increase in the number of high-risk pregnancy, the need for the special care of high-risk mothers and fetus/neonates have increased with attention drawn towards a new nursing, the maternal fetal intensive care unit (MFICU) at hospitals.

  • • What does this paper add?

  • A 2-day empowering education program for MFICU nurses experienced improvement in the levels of nursing care confidence and knowledge on caring for high-risk mother and fetus/neonates. Satisfaction toward program was high and priority areas for further attention were identified.

  • • Implications for practice, education and/or policy

  • This program can serve as a continuous education program for empowering MFICU nurses' clinical nursing knowledge and competency in terms of providing high-quality care for high-risk mothers and their fetus/neonate during the peripartum period.

References

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2. Korean Society of Maternal Fetal Medicine. The survey on the actual conditions of delivery room and delivery of high-risk pregnancy. Sejong: Korean Society of Maternal Fetal Medicine, Ministry of Health and Welfare;2012. p. 1–166.
3. Kim HY, Moon CS. Integrated care center for high risk pregnancy and neonate: an analysis of process and problems in obstetrics. Korean Journal of Perinatology. 2014; 25(3):140–152.
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5. High-risk maternal neonatal care center. Uiyank News [Internet]. Seoul: Uiyank News;2018. 12. 26. cited 2019 May 6. Available from: http://www.newsmp.com/news/articleView.html?idxno=189255.
6. Statistics Korea. E-government indicator. 2009–2017 infant and maternal mortality [Internet]. Seoul: Statistics Korea;2012. cited 2015 May 1. Available from: http://index.go.kr/potal/main/EachDtlPageDetail.do?idx_cd=2769.
7. American College of Obstetricians and Gynecologists. Society for Maternal-Fetal Medicine. Obstetric care consensus No. 6: periviable birth. Obstetrics and Gynecology. 2017; 130(4):e187–e199.
8. Ahn TG, Hwang JY. Secure plan of appropriate obstetricians and nurses for safe childbirth in Korea. Journal of the Korean Society of Maternal and Child Health. 2017; 21(1):14–23.
9. Kim HJ, Kim JI, Ahn S, Kim MH, Kim Y, Cho KS, et al. Job analysis of maternal fetal intensive care unit nurses using DACUM technique. Journal of Korean Clinical Nursing Research. 2018; 24(1):10–22.
10. Kim Y, Kim JI, Jeong GH, Kang HS, Kim M, Moon SH, et al. A survey on the educational needs and competence of nurses in maternal fetal intensive care unit. Korean Journal of Women Health Nursing. 2019; 25(2):194–206.
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11. Kim YH, Jung YS, Choi JS, Lee HY, Jung HR, Kim JS, et al. Core nursing practice and educational requirements according to nursing unit and clinical career in tertiary hospital. Journal of Korean Academy of Fundamentals of Nursing. 2015; 22(1):35–48.
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12. Kim JS, Gu MO, Jo SY. Factors influencing evidence-based practice readiness for tertiary general hospital nurses. Journal of the Korea Academia-Industrial Cooperation Society. 2013; 14(6):2945–2957.
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14. Kim HJ, Lin JS, Choi SM, Park SH, Park SH, An SE, et al. Analysis of activities and services of delivery room nurses based on DACUM technique. Journal of Korean Clinical Nursing Research. 2015; 21(3):319–334.
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ORCID iDs

Jeung-Im Kim
https://orcid.org/0000-0001-5499-8281

Mikyung Park
https://orcid.org/0000-0001-9364-5534

Gisoo Shin
https://orcid.org/0000-0001-5508-6065

Insook Cho
https://orcid.org/0000-0002-5152-9567

So Young Choi
https://orcid.org/0000-0002-0766-2053

Eun-Mi Jun
https://orcid.org/0000-0002-9997-1995

Yunmi Kim
https://orcid.org/0000-0002-6359-8033

Sukhee Ahn
https://orcid.org/0000-0002-1694-0027

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