2.50
Hdl Handle:
http://hdl.handle.net/10755/306549
Category:
Abstract
Type:
Poster
Title:
Management Strategies for the Obstetric Patient in the Emergency Department
Author(s):
Donaway, Melanie
Lead Author STTI Affiliation:
Non-member
Author Details:
Melanie Donaway, MSN, RN, CEN, CPEN, mdonaway@shorehealth.org;
Abstract:

Evidence-based Practice Abstract

Purpose: Questions and concerns are always a factor when caring for a pregnant patient. You are no longer caring for one patient but two. Who do you care for first? Being unsure could be harmful for both the mother and her fetus. To prevent any uncertainty for RNs a comprehensive set of policies and procedures were set forth utilizing evidence based practice. These policies were instituted in order to facilitate clear communication thus providing optimal care for both the mother and her fetus.

Design: In 2010 the Obstetric (OB) Department created a new policy addressing system-wide care of the pregnant trauma patient. Unfortunately, this policy did not address the Emergency Nurses Association (ENA) standard of care for the OB patient. Several Emergency Department (ED) RNs expressed their concern regarding this policy. Concerns that were addressed were the omission of an ED triage process and the exclusion of a specific definition of the types or degree of trauma. Staff also identified an absence of an ED policy/procedure to guide ED RNs in the care of the OB patient.

Setting: A rural health system comprised of one community hospital providing OB care for the area, a 40 bed community hospital, and a free-standing ED.

Participants: The participants involved in this project included ED and OB RNs, clinical educators, managers, Director of Emergency Services, and Chief Medical Director of the ED and OB Department. These leaders helped to form a well-defined multidisciplinary team.

Methods: Step One: ED RN’s and physicians discussed concerns when caring for the obstetric patient. From these discussions came a new ED policy and algorithm to provide RNs with a systematic approach for triaging the obstetric patient. Both the policy and algorithm identifies four important questions that are to be addressed when triaging. These questions include the following: Is this a pregnancy related complaint, non-pregnancy related complaint, concurrent complaint (pregnancy & non-pregnancy), or a trauma, as defined by Maryland’s EMS trauma decision tree, or a Priority 1 or Priority 2, as defined by the Emergency Severity Index (ESI)? Policy changes were reviewed by the Emergency Services Education (ESE) committee, ED and OB Professional Practice Committee, and approved by Director of Emergency Services and the ED Medical Director.

Step Two: The administrative policy on the Care of the Pregnant Trauma Patient was revised by a team of ED and OB staff. Policy changes were reviewed by the ESE committee, ED and OB Professional Practice Committee, and approved by Director of Emergency Services and the ED & OB Medical Director.

Results/outcomes: The process has cultivated a heightened awareness of care for the OB patient by the ED staff. An educational plan includes poster board presentation and didactic discussions during upcoming medical and nursing staff meetings.

Implications: This process has created more understanding and built stronger relationships between our departments. Clear, consistent communications will help improve patient satisfaction, improve inflow and outflow of patients, and most importantly provide optimal care for the OB patient.

Keywords:
Obstetric Patient in ED
Repository Posting Date:
9-Dec-2013
Date of Publication:
9-Dec-2013
Conference Date:
2013
Conference Name:
2013 ENA Leadership Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Ft. Lauderdale, Florida, USA
Description:
2013 ENA Leadership Conference Theme: Shape the Future. Held at the Greater Fort Lauderdale Broward County Convention Center
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.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePosteren_GB
dc.titleManagement Strategies for the Obstetric Patient in the Emergency Departmenten_GB
dc.contributor.authorDonaway, Melanieen_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsMelanie Donaway, MSN, RN, CEN, CPEN, mdonaway@shorehealth.org;en_GB
dc.identifier.urihttp://hdl.handle.net/10755/306549-
dc.description.abstract<p>Evidence-based Practice Abstract</p><p>Purpose: Questions and concerns are always a factor when caring for a pregnant patient. You are no longer caring for one patient but two. Who do you care for first? Being unsure could be harmful for both the mother and her fetus. To prevent any uncertainty for RNs a comprehensive set of policies and procedures were set forth utilizing evidence based practice. These policies were instituted in order to facilitate clear communication thus providing optimal care for both the mother and her fetus.</p><p>Design: In 2010 the Obstetric (OB) Department created a new policy addressing system-wide care of the pregnant trauma patient. Unfortunately, this policy did not address the Emergency Nurses Association (ENA) standard of care for the OB patient. Several Emergency Department (ED) RNs expressed their concern regarding this policy. Concerns that were addressed were the omission of an ED triage process and the exclusion of a specific definition of the types or degree of trauma. Staff also identified an absence of an ED policy/procedure to guide ED RNs in the care of the OB patient.</p><p>Setting: A rural health system comprised of one community hospital providing OB care for the area, a 40 bed community hospital, and a free-standing ED.</p><p>Participants: The participants involved in this project included ED and OB RNs, clinical educators, managers, Director of Emergency Services, and Chief Medical Director of the ED and OB Department. These leaders helped to form a well-defined multidisciplinary team.</p><p>Methods: Step One: ED RN’s and physicians discussed concerns when caring for the obstetric patient. From these discussions came a new ED policy and algorithm to provide RNs with a systematic approach for triaging the obstetric patient. Both the policy and algorithm identifies four important questions that are to be addressed when triaging. These questions include the following: Is this a pregnancy related complaint, non-pregnancy related complaint, concurrent complaint (pregnancy & non-pregnancy), or a trauma, as defined by Maryland’s EMS trauma decision tree, or a Priority 1 or Priority 2, as defined by the Emergency Severity Index (ESI)? Policy changes were reviewed by the Emergency Services Education (ESE) committee, ED and OB Professional Practice Committee, and approved by Director of Emergency Services and the ED Medical Director.</p><p>Step Two: The administrative policy on the Care of the Pregnant Trauma Patient was revised by a team of ED and OB staff. Policy changes were reviewed by the ESE committee, ED and OB Professional Practice Committee, and approved by Director of Emergency Services and the ED & OB Medical Director.</p><p>Results/outcomes: The process has cultivated a heightened awareness of care for the OB patient by the ED staff. An educational plan includes poster board presentation and didactic discussions during upcoming medical and nursing staff meetings.</p><p>Implications: This process has created more understanding and built stronger relationships between our departments. Clear, consistent communications will help improve patient satisfaction, improve inflow and outflow of patients, and most importantly provide optimal care for the OB patient. </p>en_GB
dc.subjectObstetric Patient in EDen_GB
dc.date.available2013-12-09T16:59:36Z-
dc.date.issued2013-12-09-
dc.date.accessioned2013-12-09T16:59:36Z-
dc.conference.date2013en_GB
dc.conference.name2013 ENA Leadership Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationFt. Lauderdale, Florida, USAen_GB
dc.description2013 ENA Leadership Conference Theme: Shape the Future. Held at the Greater Fort Lauderdale Broward County Convention Centeren_GB
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.en_GB
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