2.50
Hdl Handle:
http://hdl.handle.net/10755/203227
Type:
Presentation
Title:
The Oxytocin Challenge: Developing a Collaborative, Evidence-Based Approach
Abstract:
(Summer Institute) Problem: Oxytocin has been recognized as a high-alert medication and is the leading cause of obstetrical litigation. Oxytocin administration can lead to fetal acidosis from tachysystole, an increased cesarean rate and is a frequent cause of nurse-physician disagreement. Evidence: Research has shown that developing and implementing a single policy that standardizes the use of oxytocin improves outcomes and patient safety. Strategy: Physician and nurse collaboration to develop an oxytocin policy. Practice Change: Several steps were taken to create a culture change for oxytocin use. First, a policy was created and a standard order set was written based on the policy. Next, an algorithm was created constructed as a visual model of the policy. Finally, pre-use and in-use checklists were generated to ensure the close monitoring of the patient receiving oxytocin. Evaluation: Rates of cesarean sections due to non-reassuring fetal heart rate and 5 minute APGAR scores of less than or equal to 7 were compared prior to and after implementation of policy. Results: Initial results were a decrease in both cesarean section due to non-reassuring fetal heart rate and 5 minute APGAR scores. Recommendations: A standardized policy for oxytocin use and administration is effective for improving patient safety and outcomes. Lessons Learned: Implementing evidenced-based practice created an environment that fostered collaboration. The policy also improved nurse-physician communication and nursing autonomy. Bibliography: Clark, S.L., Belfort, M.A., Byrum, S.L., Meyers, J.A., & Perlin, J.B. (2008). Improved outcomes, fewer cesarean deliveries, and reduced litigation: Results of a new paradigm in patient safety. American Journal of Obstetrics and Gynecology,199(2), 105.e1-7 Clark, S.L., Simpson, K.R., Knox, G.E., & Garite, T.J. (2009). Oxytocin: New perspectives on an old drug. American Journal of Obstetrics & Gynecology, 200(1), 35e1-6. Mahlmeister, L.R. (2008). Best practices in perinatal care: Evidence-based management of oxytocin induction and augmentation of labor. Journal of Perinatal & Neonatal Nursing, 22 (4), 259-263. Miller, L.A. (2009). Oxytocin, excessive uterine activity, and patient safety: Time for a collaborative approach. Journal of Perinatal & Neonatal Nursing, 23(1), 52-58. Simpson, K.R. (2004). Management of oxytocin for labor induction and augmentation. American Journal of Maternal Child Nursing, 29(2), 136. [© Academic Center for Evidence-Based Practice, 2011. http://www.acestar.uthscsa.edu]
Keywords:
Oxytocin; Evidence-Based
Repository Posting Date:
16-Jan-2012
Date of Publication:
3-Jan-2012
Sponsors:
UTHSCSA Summer Institute

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleThe Oxytocin Challenge: Developing a Collaborative, Evidence-Based Approachen_GB
dc.identifier.urihttp://hdl.handle.net/10755/203227-
dc.description.abstract(Summer Institute) Problem: Oxytocin has been recognized as a high-alert medication and is the leading cause of obstetrical litigation. Oxytocin administration can lead to fetal acidosis from tachysystole, an increased cesarean rate and is a frequent cause of nurse-physician disagreement. Evidence: Research has shown that developing and implementing a single policy that standardizes the use of oxytocin improves outcomes and patient safety. Strategy: Physician and nurse collaboration to develop an oxytocin policy. Practice Change: Several steps were taken to create a culture change for oxytocin use. First, a policy was created and a standard order set was written based on the policy. Next, an algorithm was created constructed as a visual model of the policy. Finally, pre-use and in-use checklists were generated to ensure the close monitoring of the patient receiving oxytocin. Evaluation: Rates of cesarean sections due to non-reassuring fetal heart rate and 5 minute APGAR scores of less than or equal to 7 were compared prior to and after implementation of policy. Results: Initial results were a decrease in both cesarean section due to non-reassuring fetal heart rate and 5 minute APGAR scores. Recommendations: A standardized policy for oxytocin use and administration is effective for improving patient safety and outcomes. Lessons Learned: Implementing evidenced-based practice created an environment that fostered collaboration. The policy also improved nurse-physician communication and nursing autonomy. Bibliography: Clark, S.L., Belfort, M.A., Byrum, S.L., Meyers, J.A., & Perlin, J.B. (2008). Improved outcomes, fewer cesarean deliveries, and reduced litigation: Results of a new paradigm in patient safety. American Journal of Obstetrics and Gynecology,199(2), 105.e1-7 Clark, S.L., Simpson, K.R., Knox, G.E., & Garite, T.J. (2009). Oxytocin: New perspectives on an old drug. American Journal of Obstetrics & Gynecology, 200(1), 35e1-6. Mahlmeister, L.R. (2008). Best practices in perinatal care: Evidence-based management of oxytocin induction and augmentation of labor. Journal of Perinatal & Neonatal Nursing, 22 (4), 259-263. Miller, L.A. (2009). Oxytocin, excessive uterine activity, and patient safety: Time for a collaborative approach. Journal of Perinatal & Neonatal Nursing, 23(1), 52-58. Simpson, K.R. (2004). Management of oxytocin for labor induction and augmentation. American Journal of Maternal Child Nursing, 29(2), 136. [© Academic Center for Evidence-Based Practice, 2011. http://www.acestar.uthscsa.edu]en_GB
dc.subjectOxytocinen_GB
dc.subjectEvidence-Baseden_GB
dc.date.available2012-01-16T11:04:31Z-
dc.date.issued2012-01-03en_GB
dc.date.accessioned2012-01-16T11:04:31Z-
dc.description.sponsorshipUTHSCSA Summer Instituteen_GB
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