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Thank you so much TiffyRN! This is very helpful insight.

Thanks klone! I have come across those two and was curious if anyone has complaints/issues first hand from implementing delayed cord clamping. The preterm benefits are outstanding for something as easy as waiting a matter of seconds to clamp the cord. It's great to hear your facility implements 60 seconds! Thanks again for responding.

I'm doing my BSN Capstone Project on delayed cord clamping and am curious if anyone practices it in their facility. My project is aimed towards the benefits of implementing delayed cord clamping and would love any opinions, particularly negative feedback so I can present all sides. All of my evidence-based research has come up empty handed on any negative aspects of implementing. I have a handful of friends in L&D and have yet to come across any facilities who practice it. Personally I am all for it. The benefits far outweigh the risks and I have yet to come across any evidence-based practice for immediate cord clamping or against delayed cord clamping. However there isn't much clinical opinion from those who actually practice it and their thoughts. Thanks! Yes this is homework and no I'm not looking for anyone to do it for me :)

Thanks so much GrnTea! Yeah I guess the OB nursing forum makes more sense :)

Does anyone work in L&D? I'm doing my BSN Capstone Project on delayed cord clamping and am curious if anyone practices it in their facility. My project is aimed towards the benefits of implementing delayed cord clamping and would love any opinions, particularly negative feedback so I can present all sides. All of my evidence-based research has come up empty handed on any negative aspects of implementing. I have a handful of friends in L&D and have yet to come across any facilities who practice it. Personally I am all for it. The benefits far outweigh the risks and I have yet to come across any evidence-based practice for immediate cord clamping or against delayed cord clamping. However there isn't much clinical opinion from those who actually practice it and their thoughts. Thanks! Yes this is homework and no I'm not looking for anyone to do it for me :)

I appreciate everyones suggestions as this is my first post. I should have clarified it is all my own research and can see how posting my own opinion first would have helped. Thanks.

AH I see, not supposed to have homework questions? I was not aware. I wrote all of the information I posted, just looking for impressions from other nurses to write a section on how colleagues feel about this "new" avenue of nursing. I became an RN in November 2013 and found out I was pregnant with our 4th child so I decided to work on my BSN instead. With that being said, I sometimes feel like perhaps I'm a bit naive in how I see the world of nursing being I have never officially practiced with my license. As far as the future of nursing and what the IOM and ACA are working on to evolve nursing I think it is all amazing and am hopeful the recommendations will come through on all levels. Specifically in regards to the 3 I wrote about above, I feel these types of care models help push nurses to the forefront and encourage the "respect" they deserve. Unfortunately, I feel there are still many people in healthcare as well as patients, family members etc. who view nurses as the doctors "assistant" and really have no idea the extent of what and RN license entails. These models create roles for of leadership for nurses and allow us to have a voice in critical decision making when it comes to healthcare. And why shouldn't we ~ we are the ones on the front lines with, in my opinion, the best for pushing through with researching and implementing evidence based practice. My favorite of the three is the concept nurse-managed health clinics, I feel that would be amazing for collaboration and patient care.

Hello! Yes homework. I'm suppose to see how my colleagues feel about the patient care models i wrote about above. However, I'm not working so don't have any "colleagues" in a work sense. This is my first post. I had no idea this forum existed! I have a feeling I will be up all night checking out all the posts ~ great information!

How do you feel about accountable care organizations (ACO), medical homes, and nurse-managed health clinics? I'm working on gathering opinions of how nurses feel about the future of nursing in regards to these patient care models. Any thoughts would be greatly appreciated! Here is a little background in case you are not familiar: Accountable Care Organizations "Accountable Care Organizations (ACOs) are groups of health care providers that work as a team to coordinate care for a group of patients, with the goals of providing high-quality, patient-centered care and reducing costs" (National Alliance for Quality Care, 2013). ACO's focus on better healthcare via efforts to improve quality and reduce costs across the care continuum. They are designed to encourage the cultural change necessary to achieve the 'Triple Aim' which includes better health for the population, higher quality care, and lower costs of care. Additionally, they strive to provide smooth, continuous, high-quality care instead of the fragmented care in Medicare's current fee-for-service model. Nurses have an integral role to play "acting as care coordinators, communicators, quality improvement managers and providers of advanced levels of care" (National Alliance for Quality Care, 2013). Medical Homes Patient-centered medical homes (PCMHs) are primary care practices in which patients receive coordinated, interdisciplinary and interprofessional care. A personal health care provider maintains a continuous patient relationship and manages a team that takes responsibility for the continuum of care. The team often consists of physicians, APRNs and other nurses who all strive to provide integrated patient-centered care. PCMH utilizes strategies such as team approach, collaboration with other providers, care coordination, self-management and health information technology. Care is arranged to meet the patient's short and long-term healthcare goals, throughout every stage of life, settings, and care levels. An APRN may lead PCMH in certain states that authorize nurse-led practices. Nurses are pivotal in coordinating care and especially during transitions in care. Nurses bring the concept of holistic patient care to PCMHs that physicians often lack. This type of care delivery model allows patients to be at the center of their health care coordination with accessible primary care (Case Di Leonardi, 2015). Nurse-Managed Health Clinics Nurse-managed health clinics (NMHCs) are accessible service sites that deliver community-based primary and/or wellness care regardless of a patient's ability to pay. They provide primary health care experience with underserved populations. Nurses provide the majority of care; a team of advanced practice nurses, RNs and other health care professionals in collaboration with physicians in jurisdictions where required. The dominant theme for NMHCs is that nurses control their own practice and provide the care. "NMHCs serve as critical access points to keep patients out of the emergency room, saving the healthcare system millions of dollars annually" (American Association of Colleges of Nursing, 2013). NMHCs provide clinical placements for undergraduate and graduate nursing students necessary to increase the enrollment in nursing education programs, helping to eliminate shortages in the supply of nurses (Sutter-Barrett, Sutter-Dalrymple, & Dickman, 2015). This exposure enhances the chance that the students will select to practice in underserved areas. NMHCs give students the unique opportunity to integrate classroom learning with community-based care. American Association of Colleges of Nursing. (2013, May 16). Nurse‐managed health clinics: Increasing access to primary care and educating the healthcare workforce. Retrieved from American Association of Colleges of Nursing: http://www.aacn.nche.edu/government-affairs/FY13NMHCs.pdf Case Di Leonardi, B. (2015, January 16). The role of the nurse in transforming healthcare. Retrieved from RN.com: The Future of Nursing Report: The Role of the Nurse in Transforming Healthcare National Alliance for Quality Care. (2013, May 1). The role of nurses in accountable care organizaitons. Retrieved from National Alliance for Quality Care: http://www.naqc.org/main/resources/nursesrole-accountablecareorg.pdf Sutter-Barrett, R., Sutter-Dalrymple, C., & Dickman, K. (2015). Bridge care nurse-managed clincis fill the gap in health care. Journal for Nurse Practitioners, 11(2), 262-265. doi:10.1016/j.nurpra.2014.11.012