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Nurses and midwives: Partnering to prevent FASDs

Author(s): Beth Kelsey, EdD, APRN, WHNP-BC, FAANP; Alexandra Edwards, MA; and Marilyn Pierce-Bulger, MN, FNP-BC, CNM
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Nurses and Midwives: Partnering to Prevent FASDs is a coalition of the American College of Nurse-Midwives, the Association of Women’s Health, Obstetric and Neonatal Nurses, the National Association of Nurse Practitioners in Women’s Health (NPWH), and the University of Alaska Anchorage. The goal of this coalition is to raise awareness among, and provide education and training opportunities to, women’s health nurses and midwives about preventing alcohol-exposed pregnancies and fetal alcohol spectrum disorders (FASDs).

This coalition is part of the wider Centers for Disease Control and Prevention (CDC)-supported Collaborative for Alcohol-Free Pregnancy, a group of national partners that includes professional organizations, medical societies, university centers, and a variety of practitioners from six health disciplines working together to prevent FASDs through activities that:

Promote member awareness of risky alcohol use, including any alcohol use during pregnancy;

Promote the use of science-based messages and clinical guidelines that support implementation of alcohol screening and brief intervention; and 

Build and expand networks of champions to promote awareness activities and disseminate resources.

Please join us. We are inviting all nurses and midwives to be part of  our network of FASD champions. 

FASD champion activities

FASD champions help disseminate science-based information on the health risks associated with, as well as the strategies for preventing, alcohol-exposed pregnancies and FASDs among their colleagues, students, coworkers, and patients. 

FASD champions can choose from a variety of activities to help spread the word. For example, as a member of the FASD champions network you can:

Use patient education information in your clinical practice.

Display patient  education posters and infographics in your office.

Incorporate FASD-related articles and research findings in a nursing or midwifery course you teach.

Encourage your workplace to adopt routine alcohol screening and brief intervention.

Invite your coworkers to view an FASD prevention webinar.

Present facts on prevention of alcohol-exposed pregnancies and FASDs at a local, state, or regional healthcare professional meeting. 

Present facts on prevention of alcohol-exposed pregnancies and FASDs at a community health event.

Write an article about prevention of alcohol-exposed pregnancies and FASDs for a healthcare professional or community newsletter.

When you join our network, you select what you can do and we provide the resources and support to help you do it. We invite you to visit the online forum of Nurses and Midwives: Partnering to Prevent FASDs to exchange information with other champions.

For more information about becoming a champion and how to use any of the resources, please contact Alexandra Edwards, Project Manager, Nurses and Midwives Partnering to Prevent FASDs, aeedwards@alaska.edu.

Education and training 

The CDC and the Collaborative for Alcohol-Free Pregnancy provide free online continuing education and short courses for health professionals on prevention, identification, and management of FASDs.

Optimizing Preconception Health: Preventing Unintended Teratogen Exposure in Reproductive-Aged Women is a free series of seven taped webinars 20 to 25 minutes each in length with CE credit available.

Topics include changing patterns of alcohol use among women in the United States; alcohol–the teratogen; alcohol–the teratogen: neurobehavioral impacts; routine alcohol screening; a practical response to alcohol screening; case studies for brief interventions; and preventing stigma, stereotyping, and bias related to alcohol use by women.

Two slide presentations will be available soon on the online forum of Nurses and Midwives: Partnering to Prevent FASDs.

Slide presentation 1 includes slide sets and scripts that can be used for presentations to faculty, students, and healthcare professional groups.

Slide presentation 2 includes slide sets and scripts that can be used for presentations to community groups.

Infographics, toolkits, fact sheets, and videos

The National Organization on Fetal Alcohol Syndrome (NOFAS) provides fact sheets, videos, and other resources for professionals and individuals affected by FASDs.

The NOFAS Circle of Hope (COH) is an international network of women who have consumed alcohol during pregnancy and may have a child or children with an FASD formed to support one another. COH provides a speaker’s bureau and videos from birth mothers affected by alcohol use during pregnancy.

Three graphics that can be printed and used in patient and community education are included in Box 1.

The Fetal Alcohol Spectrum Disorders Toolkit for Nurse Champions provides resources to support alcohol screening and awareness/prevention of FASDs and to inform and train both student nurses and nurses in the workforce.

The American Academy of Pediatrics toolkit includes resources to raise awareness, promote surveillance and screening, and ensure that all affected children receive appropriate and timely interventions.

The National Institute on Alcohol Abuse and Alcoholism offers presentations and educational videos, brochures and fact sheets, and guidelines for alcohol screening and brief intervention.

Practice-related resources

CDC provides information and links to resources on putting alcohol screening and brief intervention into practice.

A guide for primary care practitioners on how to use, score, and interpret the US Alcohol Use Disorders Identification Test (USAUDIT) is available.

Commonly used CPT and Medicare codes for alcohol and/or substance use screening and brief intervention are included in an online coding guide on the website of the American College of Obstetricians and Gynecologists.

See Box 2 for a list of position statements related to the prevention of alcohol-exposed pregnancies.

Journal articles

Denny CH, Acero CS, Naimi TS, Kim SY. Consumption of alcohol beverages and binge drinking among pregnant women aged 18-44 years – United States, 2015-2017. MMWR Morb Mortal Wkly Rep. 2019;68(16):365-368.

Denny L, Coles S, Blitz R. Fetal alcohol syndrome and fetal alcohol spectrum disorders. Am Fam Physician. 2017;96(8):515-522.

Hocking M, O’Callaghan F, Reid N. Women’s experiences of messages relating to alcohol consumption, received during their first antenatal care visit: an interpretive phenomenological analysis. Women Birth. 2020;33(2):e122-e128.

May PA, Chambers CD, Kalberg WO, et al.  Prevalence of
fetal alcohol spectrum disorders in 4 US communities. JAMA. 2018;319(5):474-482.

Mitchell AM, King DK, Kameg B, et al. An environmental scan of the role of nurses in preventing fetal alcohol spectrum disorders. Issues Ment Health Nurs. 2018;39(2):151-158.

McKnight-Eily LR, Okoro CA, Turay K, et al. Screening for alcohol use and brief counseling of adults – 13 states and the District of Columbia, 2017. MMWR Morb Mortal Wkly Rep. 2020;69(10):265-270.

Pierce-Bulger M. Fetal alcohol spectrum disorders are more common than we think. Women’s Healthcare: A Clinical Journal for NPs. 2020;8(3):22-27.

Beth Kelsey is Editor-in-Chief of Women’s Healthcare: A Clinical Journal for NPs, Director of Publications for the National Association of Nurse Practitioners in Women’s Health in Washington, DC, and an assistant professor in the School of Nursing at Ball State University in Muncie, Indiana. Alexandra Edwards is a research professional at the University of Alaska, Anchorage. Marilyn Pierce-Bulger is Board Vice President of the Alaska Center for Fetal Alcohol Spectrum Disorders in Anchorage and is a consultant to the Centers for Disease Control and Prevention-funded Collaborative for Alcohol-Free Pregnancy.

Web resources

sites.google.com/view/nursesmidwivespreventfasds

cdc.gov/FASDtraining

npwh.org/courses/curriculum/details/903

nofas.org/affiliates-partners/

nofas.org/circleofhope/

nursing.pitt.edu/sites/default/files/Fetal%20Environment%20TE.pdf

npwh.org/lms/filebrowser/file?fileName=Fetal%20development%20poster%20final%20.pdf

nursing.pitt.edu/sites/default/files/Mocktails%20Flyer%20w%20Logos%20%26%20NPWH%20web.pdf

nursing.pitt.edu/continuing-education/sbirt-teaching-resources/fetal-alcohol-spectrum-disorder-fasd-and-alcohol

aap.org/en-us/advocacy-and-policy/aap-health-initiatives/fetal-alcohol-spectrum-disorders-toolkit/Pages/default.aspx

niaaa.nih.gov

cdc.gov/ncbddd/fasd/alcohol-screening.html

my.ireta.org/sites/ireta.org/files/USAUDIT-Guide_2016_final.pdf

acog.org/practice-management/coding/coding-library/prevention-of-fasd-coding-quick-guide

midwife.org/acnm/files/ACNMLibraryData/UPLOADFILENAME/000000000309/ScreeningBriefInterventionPreventAlcoholExposedPregnancyMay2017.pdf

s3.amazonaws.com/website-assets-2020/wp-content/uploads/2020/02/18142214/position_statement_-_optimiz.pdf

npwh.org/lms/filebrowser/file?fileName=AEP_NPWH%20Position%20Statement.pdf

This work was supported by Cooperative Agreement Number DD000006-01 funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.

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