Early Prenatal Care Bridges: A Quality Improvement Project to Support Early Care Engagement

Background: The United States leads the West in maternal mortality, with 18.6 deaths per 100,000 births. Late prenatal care (PNC) entry, a notable problem in the United States, is associated with maternal mortality. The clinic of interest had a 15% prevalence of early PNC entry in 2023. Objective: This quality improvement study sought to assess the relationship between free initial prenatal (IPN) visits with a community nurse practitioner (NP) and early PNC care entry for uninsured pregnant adults. Methods: Guiding frameworks included King's Theory of Goal Attainment and Stevens' Star Model of Knowledge Transformation. Aims included a 2% monthly increase in early PNC appointments and completed early PNC visits. Uninsured pregnant adults (n = 20) were recruited for IPN visits. PNC entry was assessed via follow-up contacts. Results: Sixty-five percent of participants reported early PNC appointments, and 45% completed early PNC visits during the study period. Conclusions: This study supported the efficacy of NP-led IPN visits to improve PNC entry timing. Limitations included a limited sample and study period. Implications for Nursing: NP care for early pregnancies may promote early PNC entry. Future research utilizing larger samples and longitudinal formats is indicated.