Rural Nurse of the Eastern Region Education Program
Dominican Republic
DOFMI's Rural Nurse of the Eastern Region Education Program brings together and empowers nurses from all over the Eastern region of the Dominican Republic to reduce preventable deaths of mothers and newborns.
Thirty nurse leaders were selected by the National Health Service (Servicio Regional de Salud Este) to represent ten hospitals and five primary care units of the Eastern region.
The program's initial phase started in July 2019 with the introductory module of a year-long five-part workshop focused on preventing maternal and neonatal morbidity, developed by a multidisciplinary team of a nurse practitioner-midwife and physicians. Upon completing the program, the nurses earn a Certificate of Specialization in Maternal and Newborn Care from DOFMI's and the National Health Service.
Laminar flow cabin for the preparation of sterile fluids and medicines for newborn babies . First in the country in a maternity hospital.
Hospitals & Primary Care Units
Unidad de Atención Primaria Pedro Justo Carrión, San Pedro de Macorís
Hospital Municipal Dr. Pedro María Santana, San Pedro de Macorís
Hospital Ángel Ponce Pineda, San Pedro de Macorís
Hospital Dr. Jaime Oliver Pino, San Pedro de Macorís
Unidad de Atención Primaria Ingenio Angelina, San Pedro de Macorís
Hospital Regional Dr. Antonio Musa, San Pedro de Macorís
Unidad de Atención Primaria Punta Pescadora, San Pedro de Macorís
Unidad de Atención Primaria Santa Fé, San Pedro de Macorís
Hospital Dr. Alejo Martínez García, San Pedro de Macorís
Hospital Provincial Dr. Francisco A. Gonzalvo, La Romana
Hospital Señorita Elupina Cordero, Hato Mayor
Hospital Municipal El Valle, Hato Mayor
Hospital Dr. Leopoldo Martínez, Hato Mayor
Hospital Provincial Dr. Teófilo Hernández, El Seibo
Hospital Materno Infantil Nuestra Señora de la Altagracia, Higüey
INITIAL PHASE: ONE-YEAR WORKSHOP (Jul. 2019 - Sept. 2020)
Program
Module I – Introduction (Held on July 11th, 2019 – San Pedro de Macorís).
Opening remarks and program introduction
Discussion: "how do you provide prenatal care?"
Overview of pregnancy history-taking, abdominal examination, and stages of labor
Overview of pregnancy complications
Overview of newborn baby care and neonatal resuscitation
Click the following links to see news (in Spanish):
Enfermeras de zonas rurales son capacitadas en atención obstétrica
Module II – Preserving the Lives of Mothers and Babies (Held on August 15th, 2019 – San Pedro de Macorís)
Discussion: Maternal and neonatal deaths – Why do mothers and babies die? What can the nurse do to improve maternal and neonatal outcomes?
Newborn baby care (newborn initial evaluation and follow-up: history-taking and physical exam; neonatal resuscitation: "the golden minute"; risk factors for infections, jaundice, and hypoglycemia; proper handwashing and hygiene; breastfeeding; local care protocols).
Click the following links to see meeting recording (in Spanish):
Módulo 2 - Asegurando a la Mamá y a su Bebé.
Module III – Pregnancy (Held on December 4th, 2019 – San Pedro de Macorís)
Overview of reproductive anatomy and physiology
Fetal development and circulation
Before conception: how to prepare for pregnancy
Obstetric evaluation: maternal history taking, physical exam, and additional tests
Breastfeeding
Obstetric complications (pre-eclampsia, anemia, kidney infections)
Common problems during pregnancy
The adolescent mother
Local care protocols
Introduction to the S.T.A.B.L.E. program
Module IV – Labor and Delivery*
Labor and delivery evaluation: history-taking and physical examination
Management of normal labor and delivery (stages of labor)
Signs of danger during labor and delivery
Additional review of pre-eclampsia
Complications of the third stage of labor (uterine atony and hemorrhage)
Episiotomy
Click the following links to see meeting recordings (in Spanish):
Módulo 4, Parte 1, ZOOM: El Parto
Módulo 4, Parte 2, ZOOM: El Parto
Module V – Postpartum*
Postpartum evaluation: history-taking and physical examination
Postpartum complications
Family planning
Breastfeeding
* Due to COVID-19 Pandemic, five two-hour interactive videoconferences were held during August and September 2020 to discuss module IV and V topics and study cases.
In addition to the workshop, and to provide ongoing support, a web-based chat (WhatsApp group) between the nurses, the program staff, and regional health authorities is available since the start of the program. Nurses are encouraged to use this channel to share their achievements, patient-care questions, workplace limitations, or any other personal experience or comment. DOFMI’s staff also recorded additional educational material to be shared through the web-based chat.
Click the following links to see videos on Sanitation of Incubator and Equipment and on Sexually Transmitted Diseases (in Spanish):
The nurses received a work binder with crucial information for each module. Medical equipment and tools were also issued to each facility (e.g., newborn resuscitation equipment, pulse oximeters, measuring tapes, gestational wheels, Doppler fetal heartbeat monitor).
WHAT IS NEXT?
We intend to continue contributing to the growth and empowerment of these 30 nurses. We are currently developing the educational interventions to be implemented in 2021, focusing on newborn stabilization (the S.T.A.B.L.E. program) and breastfeeding. Our research team is also working on evaluating the 2019 – 2020 program's outcomes and making the proposals for our next research projects in the Eastern Region.
We look forward to strengthening our collaboration with these nurses and making a long-lasting positive impact on the Eastern region's maternal and neonatal health outcomes.
DOFMI NURSES’ PROGRAM TEAM
NURSES’ PROGRAM COORDINATORS
Estefanía Henríquez Luthje, MD. Instituto Tecnológico de Santo Domingo, Santo Domingo, Dominican Republic.
Gabriela Henríquez Luthje, MD. Universidad Iberoamericana, Santo Domingo, Dominican Republic.
EDUCATORS
Nola Holness, PhD, CNM, NP-BC. Florida International University, Nursing, Nicole Wertheim College of Nursing and Health Sciences, Florida, United States.
Angelica Floren, MD, FAAP. University of Miami, Miller School of Medicine, Department of Pediatrics, Division of Neonatology, Florida, United States.
Teresa del Moral, MD, MPH, FAAP. University of Miami, Miller School of Medicine, Department of Pediatrics, Division of Neonatology, Florida, United States.
Amaira González, MD. Hospital Regional Dr. Antonio Musa, Department of Neonatology, San Pedro de Macorís, Dominican Republic.
NATIONAL HEALTH SERVICE LIAISON
Jacklyn Villamán, MD. Chief of Maternal and Infant Division, Servicio Regional de Salud Este, Servicio Nacional de Salud, San Pedro de Macorís, Dominican Republic.
RESEARCH GROUP COORDINATORS
Nola Holness, PhD, CNM, NP-BC. Florida International University, Nursing, Nicole Wertheim College of Nursing and Health Sciences, Florida, United States.
Estefanía Henríquez Luthje, MD. Instituto Tecnológico de Santo Domingo, Santo Domingo, Dominican Republic.
RESEARCH ASSISTANTS
Jasmin Garcia, MD. Instituto Tecnológico de Santo Domingo, Santo Domingo, Dominican Republic.
María Fernanda Díaz Soto, MD. Instituto Tecnológico de Santo Domingo, Santo Domingo, Dominican Republic.
Miguel Eduardo Mejía Sang, MD. Instituto Tecnológico de Santo Domingo, Santo Domingo, Dominican Republic.
Tanya María Pablo González, MD. Instituto Tecnológico de Santo Domingo, Santo Domingo, Dominican Republic.