Women's Health: Nurse Led Innovation
Nurses are at the forefront of human-centered healthcare solutions for women's health as a primary provider who evaluates the patient's needs while applying standard medical procedures outlined by innovative technologies us as a Data Operating System. It is also important for nurses to include a gender based approach to care in order to accommodate the unique healthcare qualities of female patients.
Standard Approach to Early Induction of Labor
Successfully Reduces Unnecessary Cesarean Deliveries
- A Health Catalyst® Data
Operating System (DOS™) Platform in addition to the Labor and Delivery
Advanced Application were used at Gunnison Valley Hospital in Gunnison, Utah in order to improve labor and delivery performance.
- The Data
Operating System (DOS™) Platform combines data
warehousing features, clinical data repositories, and health information
- The Labor and Delivery Advanced Application provides information about the hospital's pregnancy patients, which is especially useful for monitoring care performance and quality measure which can be used to identify opportunities for improving care in elective early induction, primary (first time) cesarean and Nulliparous, Term, Singleton, Vertex (NTSV) cesarean births.
- By standardizing processes used for elective early induction, more women were naturally "ready" for labor and more likely to have a successful vaginal delivery, thus resulting in an 87% relative reduction in the number of elective inductions of labor prior to 39 weeks gestation.
- Considering the fact that elective early induction can lead to more cesarean deliveries, standardizing the induction care practices led to a 61.1% relative reduction in the number of NTSV cesarean deliveries.
- By using the DOS collaborative, data driven Labor and Delivery Platform which included collaboration between physicians, nursing leadership and quality improvement specialists, there was a further 49.2% relative reduction in primary cesarean deliveries due to decrease variation in labor and delivery care.
- The Labor and Delivery Platform provided essential education for the nursing staff which allowed them to better address the individual needs of the laboring mother in the context of the most effective obstetrics protocol.
Heart Disease in Women: Formulating Research Questions
- Gendered Innovations uses sex and gender analysis to enhance innovation and discovery in fields including science, engineering and medicine
- Coronary angiography, commonly used to diagnose heart disease, is more accurate for male patients while considered ineffective in diagnosing female patients.
- Ischemic heart disease is recently thought to be a more common diagnosis among women with chest pain, as opposed to men who more commonly have obstructive coronary heart disease.
- Women are more likely to have open arteries while at the same time experiencing unstable angina, acute coronary syndrome, or other coronary conditions.
- Coronary angiography is more likely to cause bleeding complications in female patients, resulting in the need to develop new angiography procedures, for example entry through the radial artery.
- Novel techniques that can diagnose the cause of myocardial ischemia in patients with chest pain but no obstructive coronary heart disease that would be especially beneficial for women include coronary reactivity testing, intravascular ultrasound (IVUS), cardiac magnetic resonance imaging (MRI) and cardiac spectroscopy, advanced radionuclide imaging including positron emission tomography (PET) and perfusion stress echocardiography.
- Chest pain is the most common symptom of heart disease for both men and women, while symptoms of nausea and jaw pain are found to be more common in female patients, despite the fact that these symptoms are commonly labeled as atypical.
- Accurately recognizing sex differences in symptom presentation is especially important for accurate diagnosis and timely treatment for women.
- As a result of the later stage of onset of heart disease for women as compared to men, the idea that premenopausal estrogen can protect the heart from coronary heart disease led to the estrogen hypotheses, which became challenged In 1985, when menopausal hormone therapy (MHT) use was compared with patients who did not supplement with estrogen or progesterone hormone, and it emerged that MHT led to higher rates of heart disease and no long term benefits.
- As a result of the new findings that contradicted the estrogen hypothesis, the U.S. Food and Drug Administration (FDA) requires "black box" warning on MHT products that state that they should not be used to prevent coronary heart disease.
- As a further development for the improved care of female patients, The American College of Cardiology states that “hormone therapy and selective estrogen-receptor modulators (SERMs) should not be used for the primary or secondary prevention of CVD.”
- Most risk factors for coronary heart disease such as age, high fat diets, obesity and diabetes are applicable to both men and women, while it has been found that the effects of smoking on increasing atherosclerosis is twice as severe for women as compared to men.
- A key goal of continued gendered analysis in cardiovascular research is to provide healthcare professionals better guidelines to improve care for female patients.
Searches for case studies from academic journals produced many pay walled and subscription only articles. In order to find open source case studies between 2017 to the present in the United States in the context of innovative human centered women's healthcare solutions, a case study from a healthcare technology company was selected, Health Catalyst, to demonstrate how technology can improve nursing care in obstetrics. A research based case study was selected from Stanford University Gendered Innovations in order to demonstrate how new methods of inclusive patient cardiac care, from evaluating patient symptoms to novel testing methods, can improve health outcomes especially for female patients.