Policy development: practice improvement, blind sweep fetal fibronectin collection

Abstract

Recognizing preterm labor can help guide the management of care of the mother and fetus between the obstetrician and registered nurse. A simple test called the rapid fetal fibronectin (fFN) can detect proteins that are indicators of preterm delivery. A trained registered nurse can perform this simple test, in which a swab is placed in the posterior fornix of the vagina. The March of Dimes has created a pathway for standardized preterm labor assessment developing a Preterm Labor Assessment Tool (PLAT) for hospitals to aid in the reduction preterm labor and deliveries. A positive fFN test allows for antenatal steroids and preparation for optimal neonatal care, whereas a negative fFN test allows for less intervention, avoidance of unnecessary medical treatment and hospitalization, and the provision of reassurance to both obstetrician and patient. The purpose of this project was to develop an evidence based policy that would guide and support practice improvements for the blind sweep fFN collection method. This evidence based protocol will allow trained registered nurses to perform a blind sweep fFN test without an obstetrician or residents' supervision. By performing the fFN tests on patients who present with preterm labor signs and symptoms, obstetricians will be able to recognize preterm labor assessment and initiate early treatment.