Nurse Education and Support Team (NEST) – Rural
Recognizing that the postpartum period represents a unique and sensitive period for both maternal and infant health outcomes, it has been referred to as the 4th trimester. For mothers, it is a period of intense transitions - physically, mentally and socially. For infants, it represents a period of neurodevelopmental and immunologic immaturity and vulnerability. Building on the development and implementation of a novel model for health system integrated postpartum nurse education and support (Nurse Education and Support Team - NEST), and through the support of a recently awarded grant from The Duke Endowment, our team is launching a randomized controlled trial evaluating the impact of the NEST model in five counties, selected based on known challenges with access to postpartum care. Through NEST-Rural, mothers delivering at the Atrium Health Wake Forest Baptist Birth Center and randomized to the NEST-Rural model of care will receive an initial encounter from a NEST Coordinator while in the inpatient postpartum unit. At this visit, the mother will receive a remote blood pressure monitor and any acute needs will be addressed (e.g. need for diapers, food). Further, they will be scheduled for their first follow-up NEST visit. Based on established criteria, families will be offered either a home visit or a virtual telehealth visit. The primary objectives of the intervention are to support improved adherence to established guidelines and reduce inpatient readmissions, ED visits and OB triage encounters.
The NEST-Rural team includes Co-Leaders, Drs. Jensen (Epidemiology and Prevention) and Stamilio (Maternal and Fetal Medicine, Obstetrics and Gynecology, with a secondary appointment in Epidemiology and Prevention), Dr. Cochrane (Obstetrics and Gynecology, with a secondary appointment in Epidemiology and Prevention), Dr. Kline (Biostatistics and Data Science with secondary appointment in Epidemiology and Prevention), Dr. Ingle (Director of Nursing, Birth Center), Dr. Padagashwar (Hospitalist), Dr. Anna Miller-Fitzwater (Pediatrics), Angie Almond (Project Manager) and Charity Watterson (Nurse Supervisor and Study Operations).