Journal of obstetric, gynecologic, and neonatal nursing : JOGNN
December 31, 2025 · via Europe PMC
Implementation of a Nurse-Initiated Protocol for Prenatal Care in a Carceral Setting.
Stevenson J, Knittel AK, Crowell NA, Heitzler ET.
AI summary — for doctors, generated from the abstract only
A nurse-initiated prenatal care protocol at a women's carceral facility significantly reduced time to order prenatal diet and schedule first obstetric appointments.
What was studied
A quality-improvement project at a Southeastern US women's carceral facility involving 44 nurses trained on a nurse-initiated intake protocol, with chart comparison of 26 pre- and 24 post-implementation incarcerated pregnant women.
Key findings
- Time to order prenatal diet and schedule first obstetric appointment decreased significantly (specific statistics not fully captured in the abstract)
- Protocol included Clinical Opiate Withdrawal Scale use
- Barriers assessed 3 months after implementation
Clinical relevance
This suggests nurse-initiated protocols may standardize and speed prenatal care in carceral settings.
Who should care
Limitations
Small single-site QI project with limited patient numbers; clinical outcomes not measured.
Empowering nurses with a protocol speeds prenatal care for incarcerated women.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Objective
To evaluate the effect of a nurse-initiated protocol on the times to order and implement prenatal care, nurses' intentions to change practice based on an educational session, and nurses' perceived barriers to initiation of the protocol in a carceral facility.
Design
Quality improvement project.
Setting/local problem
Southeastern United States carceral facility.
Participants
A total of 44 nurses employed by a state women's carceral facility.
Intervention/measurements
Participants attended a 30-min educational session on a nurse-initiated intake protocol, including use of the Clinical Opiate Withdrawal Scale. The session was offered multiple times during shifts to maximize attendance. Participants then completed an adapted Continuing Professional Development-Reaction Questionnaire. We abstracted de-identified data from the charts of adult incarcerated women in the pre-implementation (n = 26) and post-implementation (n = 24) phases. We compared time to order (interval from admission to entry of order for a laboratory test, medication, or intervention) and time to implementation (interval from entry of order to initiation of the laboratory test, medication, or intervention) before and after implementation of the protocol. We assessed barriers to implementing the protocol 3 months after implementation.
Results
The time to order a prenatal diet and schedule a first obstetric appointment decreased significantly (p < .001), whereas the time to order prenatal labs increased significantly (p = .03) after implementation of the protocol. We identified the following themes as barriers to implementing the protocol: Lack of Integration of the Protocol Into the Electronic Health Record, Interruptions in the Flow of Care, and Limited Resources.
Conclusions
Use of a nurse-initiated protocol standardized and improved the timeliness of the delivery of prenatal care in a carceral facility and has the potential to enhance health care quality and maternal-fetal outcomes in this high-risk population.
DOI
10.1016/j.jogn.2025.12.006
PMID
41483873
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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