2.50
Hdl Handle:
http://hdl.handle.net/10755/164058
Category:
Abstract
Type:
Presentation
Title:
Care of the Critically Ill Obstetrical Patient
Author(s):
Tyer, Viola, Lynda A.; Brush, Kathryn A.
Author Details:
Lynda A. Tyer-Viola, RNC, PhD-C, Massachusetts General Hospital, Boston, Massachusetts, USA, email: nacnsorg@nacns.org; Kathryn A. Brush, RN, MS, CCRN, FCCM
Abstract:
Problem: Pregnant women with co morbid disease or obstetrical emergencies requiring multisystem monitoring present a challenge to high occupancy tertiary medical centers. Purpose/Objectives: The purpose of this poster is to describe a multidisciplinary approach to care for the critically ill parturient in an academic medical center. Background/Rationale: The critically ill obstetrical patient is a challenge for all obstetrical services. Approximately 2% of patients annually require care by an interdisciplinary team to assure maternal stability and enhanced fetal viability. More women with co morbid disease are carrying their pregnancies to term and require invasive hemodynamic monitoring as well as fetal monitoring during delivery. The care of these women is manpower intensive and can present significant challenges to nursing as well as anesthesia resources. Description of the Project: The Vincent Obstetrical Service was reestablished after 40 years at the Massachusetts General Hospital in 1994. The Maternal Fetal Medicine Service cared for a variety of women with co morbid disease of pregnancy such as cardiac anomalies and/or hemodynamic disorders requiring invasive monitoring. Although their needs were well defined by consulting physicians, there was limited operational planning for these patients. In 2000, the perinatal team proposed a plan to prospectively plan for our high risk patients by collaborating with the Surgical Intensive Care Unit. The plan involves the evaluation of the patients obstetrical and intensive care needs by the respective CNS team and communication of a plan of care with supporting literature for the nursing staff. Outcomes: The program has created an OB Intensive Care Policy for the critically ill parturient that is activated via the ICU triage nurse. At risk patients now have a coordinated delivery in the ICU with obstetrics, anesthesia, and intensive care team members in attendance. This program has also resulted in decreased placement and transfer time to the SICU during obstetrical emergencies and decreased LOS due to the patient being moved sooner, interventions activated and weaning and/or invasive monitoring discontinued in a timely manner with the family returning to the postpartum care unit. Interpretation/Conclusion: The CNS role is critical in providing a plan of care that incorporates the potential interdisciplinary needs of the patient and family. The CNS team is responsible to their nursing colleagues to provide additional resources and education support for this unique patient population. Implications for Nursing Practice: The implications for practice include the ability to utilize existing intensive care resources to create a safe birth experience while respecting cultural beliefs and meeting women's labor expectations.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2004
Conference Name:
2004 NACNS Conference, Renaissance in CNS Practice: Transforming Nursing in the 21st Century
Conference Host:
NACNS - National Association of Clinical Nurse Specialists
Conference Location:
San Antonio, Texas, USA
Description:
Conference theme: Renaissance in CNS Practice: Transforming Nursing in the 21st Century, held on March 11 to 13, 2004 in San Antonio, Texas, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleCare of the Critically Ill Obstetrical Patienten_GB
dc.contributor.authorTyer, Viola, Lynda A.en_US
dc.contributor.authorBrush, Kathryn A.en_US
dc.author.detailsLynda A. Tyer-Viola, RNC, PhD-C, Massachusetts General Hospital, Boston, Massachusetts, USA, email: nacnsorg@nacns.org; Kathryn A. Brush, RN, MS, CCRN, FCCMen_US
dc.identifier.urihttp://hdl.handle.net/10755/164058-
dc.description.abstractProblem: Pregnant women with co morbid disease or obstetrical emergencies requiring multisystem monitoring present a challenge to high occupancy tertiary medical centers. Purpose/Objectives: The purpose of this poster is to describe a multidisciplinary approach to care for the critically ill parturient in an academic medical center. Background/Rationale: The critically ill obstetrical patient is a challenge for all obstetrical services. Approximately 2% of patients annually require care by an interdisciplinary team to assure maternal stability and enhanced fetal viability. More women with co morbid disease are carrying their pregnancies to term and require invasive hemodynamic monitoring as well as fetal monitoring during delivery. The care of these women is manpower intensive and can present significant challenges to nursing as well as anesthesia resources. Description of the Project: The Vincent Obstetrical Service was reestablished after 40 years at the Massachusetts General Hospital in 1994. The Maternal Fetal Medicine Service cared for a variety of women with co morbid disease of pregnancy such as cardiac anomalies and/or hemodynamic disorders requiring invasive monitoring. Although their needs were well defined by consulting physicians, there was limited operational planning for these patients. In 2000, the perinatal team proposed a plan to prospectively plan for our high risk patients by collaborating with the Surgical Intensive Care Unit. The plan involves the evaluation of the patients obstetrical and intensive care needs by the respective CNS team and communication of a plan of care with supporting literature for the nursing staff. Outcomes: The program has created an OB Intensive Care Policy for the critically ill parturient that is activated via the ICU triage nurse. At risk patients now have a coordinated delivery in the ICU with obstetrics, anesthesia, and intensive care team members in attendance. This program has also resulted in decreased placement and transfer time to the SICU during obstetrical emergencies and decreased LOS due to the patient being moved sooner, interventions activated and weaning and/or invasive monitoring discontinued in a timely manner with the family returning to the postpartum care unit. Interpretation/Conclusion: The CNS role is critical in providing a plan of care that incorporates the potential interdisciplinary needs of the patient and family. The CNS team is responsible to their nursing colleagues to provide additional resources and education support for this unique patient population. Implications for Nursing Practice: The implications for practice include the ability to utilize existing intensive care resources to create a safe birth experience while respecting cultural beliefs and meeting women's labor expectations.en_GB
dc.date.available2011-10-27T11:41:13Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:41:13Z-
dc.conference.date2004en_US
dc.conference.name2004 NACNS Conference, Renaissance in CNS Practice: Transforming Nursing in the 21st Centuryen_US
dc.conference.hostNACNS - National Association of Clinical Nurse Specialistsen_US
dc.conference.locationSan Antonio, Texas, USAen_US
dc.descriptionConference theme: Renaissance in CNS Practice: Transforming Nursing in the 21st Century, held on March 11 to 13, 2004 in San Antonio, Texas, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_US
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