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How a simple menu is helping expectant moms manage pain … and impacting care across Mary Greeley.
by Stephanie Marsau
Kirstie Hassebrock scanned the menu and decided the peanut ball sounded good.
No, that is not a dessert, and Hassebrock was not looking at any ordinary menu.
The expectant mom on Mary Greeley’s Birthways obstetrics unit was looking at a “comfort menu,” which provides patients with a big list of items they can select to help manage pain and make their hospital visit more comfortable.
Amy Dagestad, MSN, RN, director of Maternal and Child Services at Mary Greeley, learned about a concept similar to comfort menus at a 2018 Iowa Healthcare Collaborative conference and wanted to try it on Birthways. Coincidentally, Alison Sebbag, BSN, RN, a nurse on Mary Greeley’s Birthways unit, approached Dagestad about this same idea not knowing that Dagestad was already on the same page. The two set out to create something that would significantly enhance the patient experience on Birthways and beyond.
To develop the Birthways comfort menu, Dagestad and Sebbag wanted to survey 50 random patients about how their pain had been managed during their stay. The pair had to go before Mary Greeley’s Institutional Review Board and present their idea. The board has the authority to approve, reject, or require modifications to research proposals. Permission to do the patient surveys was granted. Using patient insights, Mary Greeley’s comfort menu began to take shape.
Birth of the Comfort Menu
In February 2019, the comfort menu was launched on Birthways.
“What we really wanted to achieve through the use of the comfort menu was to give patients more control regarding how to manage their pain,” said Dagestad. “We deliver more than 1,100 babies a year, and a lot of those mothers don’t want to rely on pain medication to help them through the birthing process.”
When a patient is admitted to Birthways, the comfort menu is awaiting them in their room. Similar to a restaurant, a patient can look over the menu and let their nurse know what items they would like to try.
The menu has four main categories: comfort, personal care, comfort actions, and relaxation. Each category serves its own unique purpose depending on how the mother is feeling and where she is in the birthing process.
A Comfortable Mom
Hassebrock, mom of one with another on the way, had been a little bit in labor for weeks. At her 38-week appointment, her obstetrician decided that she would be induced the following week.
Having already had one child, she knew what to expect but this was the first child she was having at Mary Greeley.
Induced shortly before 8 a.m., the morning went slow; but around 1:30 p.m., contractions started to intensify. Acting on the nurse’s suggestion, Hassebrock decided to look at the comfort menu.
“My eye was immediately drawn to the Comfort Actions section,” Hassebrock recalled. “I was trying to manage some serious contractions, and I knew that I needed something that would help alleviate some of that pain.”
Hassebrock chose to try the peanut ball, which was listed under the Comfort Actions section. The ball, shaped like a peanut, can be used by a laboring mother to help the birthing process. The ball is placed between her legs, which helps keep the hips in an optimal position. This position helps widen the pelvis, which helps the baby descend, thus speeding up delivery.
By the time she received the peanut ball, Hassebrock had been laboring for almost seven hours. Approximately an hour and a half later, she gave birth to a healthy baby boy named Grayson.
“I never would’ve thought about asking for the peanut ball if it hadn’t been on the comfort menu,” said Hassebrock. “I wasn’t sure what to expect since our first child wasn’t born at Mary Greeley but I cannot recommend Birthways enough. Just being able to see a list of things available to help me in the process, put me at ease. It was an added bonus that the item I chose seemed to speed up Grayson’s delivery.”
The comfort menu has been so well received on the Birthways unit, that different versions have been implemented on three of Mary Greeley’s other inpatient units: Medical Telemetry, Medical-Surgical, and Oncology (see sidebar).
“We know that pain management is a pivotal part of an obstetric patient’s experience both during and after delivery,” said Dagestad. “We also know that obstetric patients are obviously not the only ones who experience pain while in the hospital. Rolling those out to more inpatient units allows patients outside of Birthways to choose their own personal comfort methods to help alleviate their pain.”
Spreading the Menu
Popular Birthways service embraced by other inpatient units.
With its success on Birthways, comfort menus have found a patient care role on other inpatient units at Mary Greeley.
The concept was readily embraced by Mary Greeley’s Nursing Practice Council. There are some minor differences between the Birthways comfort menu and those on other inpatient units. Patients can ask for a heating pad, to be repositioned or for a fan. To help them relax, they want to take advantage of an inpatient massage, have their lights dimmed or visit the rooftop garden.
The menu for patients on the Oncology Unit has also been designed with that specific patient population in mind. Oncology patients will find items that can help with chemo-associated nausea.
Sarah Heikens, director of Mary Greeley’s Oncology Unit and ICCU, thinks the comfort menu is an excellent way to better care for patients and reduce any anxiety they may have.
“The comfort menu is nice in that it lists all of the different options for patients in one place,” Heikens said. “Staff may not think of a visit to the rooftop garden, or a diffuser, as ways to reduce patient anxiety. Every patient is different though, so if a patient sees something on the comfort menu that might help them, it allows us get them what they need to help them feel better.”