Date of Award

January 2025

Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Yale University School of Nursing

First Advisor

Joan Combellick

Abstract

AbstractProvider Mindfulness: Changing Implicit Bias and Improving Perinatal Health Outcomes for Patients with Adverse Social Determinants of Health Purpose: Implicit bias is an unconscious prejudice or preexisting belief developed over time toward another group. It can influence provider judgement, treatment decisions and levels of care. The purpose of this DNP Quality Improvement (QI) project was to improve patient care and provider knowledge on how implicit bias affects perinatal health for those with adverse social determinants of health (SDOH). Methods: A 53-second daily mindfulness intervention was developed and implemented among 8 obstetric providers caring for a population at risk for bias and discrimination. Provider knowledge, attitude and mindfulness practice was evaluated before and after the intervention with a survey. Provider engagement was tracked via number and types of social support referrals generated on patients’ behalf. Patient experience of respectful care was evaluated with a survey before and after care from providers involved in the intervention. Results: Post-implementation survey results indicated 63% of providers were willing to incorporate mindfulness into practice. 64% of patients received one or more social support referrals. There were no statistically significant outcomes, however qualitative analysis of providers pre and posttest indicated some benefit. Patients had a very weak negative Pearson correlation between pre and posttest outcomes. Patients’ paired t-test indicated no statistically significant difference in perceptions of respectful care pre and posttest. viii Conclusion: Although there were no statistically significant outcomes, benefits were seen. Provider posttest results were positive. Patients’ perceptions of respectful care were high throughout. Repeating this project is warranted, as statistical significance was limited by number of participants.

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This is an Open Access Thesis.

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