Group β Streptococcus Education for Pregnant Women at a Birth Center

Abstract

Group β Streptococcus (GBS) is an anaerobic Gram-positive bacteria that can colonize the genitourinary tract and place the newborn at risk for infection during the intrapartum and postnatal period. Due to this risk of vertical transmission, pregnant women are screened between 35 and 37 weeks gestation for GBS colonization. To prevent newborn GBS disease, intrapartum intravenous prophylactic antibiotics are administered. Failure to screen and treat for the bacterium can lead to early-onset GBS disease in the newborn. In a freestanding birth center in North Carolina (NC), Certified Nurse-Midwives (CNMs) educate their clients about GBS colonization and management during the intrapartum period. During April, May, and June of 2016 only 60% (3/5), 75% (3/4), and 43% (3/7) respectively of the women at the facility received adequate GBS prophylaxis during labor. The purpose of this Doctor of Nursing Practice (DNP) project was to increase the percentage of women with GBS colonization who receive sufficient GBS prophylaxis during the intrapartum period. A GBS patient education algorithm was implemented for use by CNMs at the birthing center. CNMs were provided printed patient education materials from the Centers for Disease Control and Prevention (CDC) and the American College of Nurse-Midwives (ACNM) on GBS screening and prophylaxis between 35 and 37 weeks gestation. Following a 90-day implementation period, the percentage of patients that received sufficient GBS prophylaxis increased from 56.52% (13/23) to 58.6% (17/29). Post implementation there was a rise in sufficient GBS prophylaxis and the CNMs perceived an improvement in patient knowledge about GBS.