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Disruptive Nurses Lead to Better Outcomes

Alexandra Wilson Pecci, for HealthLeaders Media, October 15, 2013

Here's how the model works: 8 to twelve women with similar gestational ages meet 10 times in a group throughout their pregnancies, learning all the things and getting all the exams they'd get in traditional prenatal care, but with the added benefit of a community setting. It's a model that women and providers love, Rising tells me.

Twenty years later, the Centering model has gained national traction, with multiple new studies proving its effectiveness and CMS grants to create CenteringPregnancy sites across the country.

For instance, a 2007 multi-site randomized controlled trial found that participation in CenteringPregnancy care reduced the risk of premature birth by 33% compared to traditional prenatal care and "resulted in equal or improved perinatal outcomes at no added cost."

Another study, published in May 2012, showed that "participation in group care improves the rate of preterm birth compared with traditional care, especially among black women." And a study in August 2013 issue of the American Journal of Obstetrics and Gynecology showed that the more closely facilitators stuck to Centering model, the better the outcomes actually were.

Rising says she conducted her first pilot of the model at the Waterbury Hospital Clinic in Waterbury, CT, where she'd been providing midwifery care for several years.

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1 comments on "Disruptive Nurses Lead to Better Outcomes"


Chris (10/17/2013 at 1:36 AM)
I read the article and still apply my personal philosophy that conclusions are derived applying current knowledge and experience from an individual's perspective. A statement might be correct if applying current knowledge, but consider not only if such knowledge is verifiable with EBP, but does that knowledge encompass all aspects and variables? An RN might view changes as disruptive, concurrently, administration might see the whole picture with a positive outlook. I disagree with the article almost entirely, being disruptive may be subjective based on those perceiving the disruption, but from my limited experience disruption does not promote harmonious productivity toward any goal. Forget ripping the box to shreds, that is destructive....instead comply with ANA/State Board rules, and view the box as a dynamic cube. I would also question those that built the initial box if it had to be ripped. Perhaps those that are disruptive do not posses the spatial or critical thinking abilities to properly utilize available resources, not realize the availability of them or the long-term consequences. I do agree with the intended result positive deviants have, as I challenge everything everywhere in every aspect within my Scope of Practice. Achieving a goal more efficiently or effectively can be tested with theoretical simulations and algorithms or apply multiple PDSA cycles to eliminate all variables to achieve end result. Change may be disruptive or viewed as such if the implementation of it and relevant variables are not considered. I am very motivated and passionate to promote excellent and efficient health in every aspect, yet rationally inquisitive to seek opportunities for safe effective changes. By disagreeing with the article might I be perceived as disruptive or courageous?