Marilyn Stringer

As a master teacher in women’s health nursing, Dr Stringer has coupled clinical expertise and leadership in nursing education and practice. Dr. Stringer has changed the paradigm of advanced practice nursing with the incorporation of a highly sophisticated method of fetal assessment, limited obstetrical ultrasonography (LOBU), known to improve birth outcomes by reducing infant morbidity and mortality. As one of a small number of nurses nationally certified in diagnostic obstetrical and gynecological ultrasonography, Dr. Stringer influenced national and international standards and incorporated this valuable assessment technique into the discipline of advanced nursing practice. At Penn, Dr. Stringer developed a highly innovative and well-recognized curriculum that provides a framework for teaching the required didactic and clinical skills for performance of LOBU. This curriculum serves as a model for schools in the U.S. and internationally. The unique offering of LOBU content at Penn Nursing places our graduates in the position of preferred employees, locally, regionally, and nationally. Our graduates were among the first Advanced Practice Nurses to expand their roles in obstetrical out-patient triage centers (sites for pregnant women’s episodic care), as well as obstetrical and gynecological in-patient settings. In Egypt, with its high perinatal morbidity and mortality rates, Dr. Stringer was solicited by Project Hope to provide evidence-based didactic and clinical skill education targeted to increase assessment and autonomy of practice to improve maternal/infant outcomes. Due to her efforts, LOBU is an emergent field of advancing nursing practice in the U.S. and internationally.

Dr. Stringer’s clinical scholarship focuses on the promotion of a healthy pregnancy and the reduction of preterm births for high-risk women. Because preterm birth is associated with the highest rates of perinatal morbidity and mortality rates, Dr. Stringer’s focuses on risks for preterm birth, including attendance at care (i.e., number of visits attended), reasons for accessing care, health promotion, and disease prevention. Past research has included a study for increasing pre-natal care compliance for working, poor women. Additionally, as a sub-study, Dr. Stringer studied pregnant teens’ attitudes and beliefs associated with vaccination of Human Papillomavirus (HPV) and Hepatitis B. The results of that study will be used to implement postpartum vaccine delivery in the near future. Continuing work on attendance at prenatal care, Dr. Stringer explored prenatal emergent care, specifically symptoms described by African American women evaluated for preterm labor. Women described their complaints in language markedly different from their providers, waited long periods to access care, and consulted with family members prior to coming for care. Based on these findings, HUP has now altered its preterm labor patient teaching to use language appropriately attuned to the population served.
Currently, Dr. Stringer is engaged in a collaborative effort focused on health promotion for childbearing women in the West Philadelphia community. These childbearing women face numerous health disparities, especially high rates of preterm birth. Along with women of the West Philadelphia Community, HUP Women’s Health Department, and the School of Nursing’s (SON) Healthy in Philadelphia initiative, Dr. Stringer’s team is promoting evidence-based, sustainable interventions intended to reach at-risk women.

Dr. Stringer provided leadership to achieve eminence in women’s health nursing at the Hospital of the University of Pennsylvania (HUP) as recognized by the award of Magnet status and is currently serving on the Magnet Re-designation Board. Dr. Stringer translates evidence-based research to the rapidly changing clinical environment, where she facilitates immediate clinical adaptations in response to new research. In turn, Dr. Stringer brings new evidence and practice changes back to the classroom. Dr. Stringer has had a significant impact on patient outcomes, especially in the promotion of a healthy pregnancy and the reduction of preterm births for high-risk pregnant women. Her strong partnerships with nursing leaders and clinicians at the University of Pennsylvania Health System have allowed Dr. Stringer to play a critical role in the largest women’s health practice in the tri-state area. In her leadership role Dr. Stringer ensures an evidence-based standard of care, as reflected in system-wide policies, procedures, staff orientation events, and projects. These patient safety models have been shown to improve patient outcomes and are widely emulated as best practice resources.

Dr Stringer’s expertise has been recognized by her peers receiving numerous awards such as AWHONN’s Award of Excellence in Education, first recipient of the Exemplary Professional Practice Dean’s Award, Nursing Legacy Award, Global Engagement Award, Global Partner Award (Mahidol University, Thailand), AJN Book of the Year Award, and Division Award for Exemplary Teaching, She has been invited to serve on JOGNN’s Editoral Board, revised AWHONN’s ultrasound competency practice guidelines for nurses and has consulted on nursing ultrasound standards of care with the March of Dimes, the National Certification Corporation for obstetric, gynecologic and neonatal nursing specialties, Sigma Theta Tau International, other health care systems, as well as the legal community.