Antenatal and intrapartum care for women with gestational diabetes: a best practice implementation project

OBJECTIVES: This project aimed to improve the quality of antenatal and intrapartum care for women with gestational diabetes (GD) by increasing nursing and midwifery care compliance with best practice recommendations. INTRODUCTION: GD is one of the most common diseases that can lead to several important maternal and fetal complications. METHODS: This project was based on JBI's evidence implementation approach and included a baseline audit, the implementation of strategies, and a follow-up audit. The project was conducted in an obstetrics-gynecology department of a hospital in Bucharest, and the sample included 30 pregnant women with GD from that ward. RESULTS: Regarding antenatal care, the baseline audit revealed low compliance (63%-87%) for criterion 2 (specific education), criterion 3 (multidisciplinary team), criterion 4 (individualized care plan), criterion 5 (training on self-monitoring), criterion 8 (dietician consultation), and criterion 10 (physical exercise program). Compliance with criterion 9 (physiotherapist consultation) was nil. Higher compliance (90%-100%) was reported for criterion 1 (screening for GD), criterion 6 (self-monitoring), and criterion 7 (maintenance of glycemic values). The intrapartum care audit criteria regarding maintaining blood glucose levels had compliance rates of 97% (criteria 13 and 14), 73% (criterion 11), and 67% (criterion 12). As a result of implementing the most appropriate strategies, maximum improvement was observed for all 12 audit criteria found to be deficient in the baseline audit. CONCLUSIONS: Strategies were identified and applied to successfully implement the best practices (educational programs and improved procedures). However, specific actions, such as regular targeted audits and continuous monitoring, are needed to maintain long-term results.