While You Are Waiting: a family-focused antepartum support program.

While You Are Waiting is an antepartum support program developed for hospitalized, high-risk pregnant women. The goal of the program is to provide an atmosphere for the mother that will minimize the adverse effects of long-term activity restrictions and prolonged hospitalization. The program focuses on 4 key opportunities to promote optimal outcomes: education, support, recreation, and outreach. Details of the program and preliminary outcome data are provided.

Perinatal patient safety from the perspective of nurse executives: a round table discussion.

Six nurse executives across the United States discussed issues related to perinatal patient safety. Gaps in communication were identified as one of the biggest challenges facing nurse executives. Other issues included expectations of regulators and accreditors, the pressure for productivity with limited resources and staffing, and undercapitalized technology versus safety and staff competence. Each nurse executive discussed a perinatal patient safety initiative implemented recently in her organization. If costs were not an issue, construction of facilities, adoption of electronic documentation, and adding positions to help assure patient safety were at the top of their wish lists. Patient safety continues as the number one priority for nurse executives.

Obstetric "conveniences": elective induction of labor, cesarean birth on demand, and other potentially unnecessary interventions.

Common obstetric interventions are often for "convenience" rather than for clinical indications. Before proceeding, it should be clear who is the beneficiary of the convenience. The primary healthcare provider must make sure that women and their partners have a full understanding of what is known about the associated risks, benefits, and alternative approaches of the proposed intervention. Thorough and accurate information allows women to choose what is best for them and their infant on the basis of the individual clinical situation. Ideally, this discussion takes place during the prenatal period when there is ample opportunity to ask questions, reflect on the potential implications, and confer with partners and family members. A review of common obstetric interventions is provided. While these interventions often are medically indicated for the well-being of mothers and infants, the evidence supporting their benefits when used electively is controversial.

Nursing leadership in the boardroom.

It is critical that nurse leaders, including chief nurse executives and service line directors, be part of the institutional decision-making process about resource allocation, strategic direction, and planning for the future. Nurse leaders can use numerous strategies to influence decisions made in the boardroom that affect the women's service line, including perinatal and women's health. These strategies include building on the importance of women's services to the organization, working in collaboration with senior leaders and key physician leaders, marketing, and reaching out to governing boards with information. Nurse leaders must continue to prepare for the future to thrive in the increasingly complex health care environment.