Another Set of Eyes: Remote Fetal Monitoring Surveillance Aids the Busy Labor and Delivery Unit :...
-
Upload
donna-williams -
Category
Documents
-
view
212 -
download
0
Transcript of Another Set of Eyes: Remote Fetal Monitoring Surveillance Aids the Busy Labor and Delivery Unit :...
of the Executive Medical Director and the Clinical
Nurse Specialist formed to review reasons for
delays and evaluate the work£ow for unscheduled
Cesarean delivery. The team created a new
work£ow that included additional resources, delin-
eation of roles, clari¢cation of communication,
and streamlined procedures. The team provided
education on the new work£ow to medical and
nursing sta¡, and the change was implemented.
The new work£ow was practiced and reinforced
for approximately 3 weeks before data collection
resumed.
Ourgoal is to achieve a decision-to-incision interval
of 30 minutes or fewer for all unscheduled Cesar-
ean deliveries. As we move forward with this project
we are collecting feedback, identifying unforeseen
issues, and revising the work£ow as necessary. Ini-
tial data collection (including only 2 weeks of
deliveries) revealed improvement in the frequency
of meeting the 30-minute standard for all unsched-
uled Cesarean deliveries (33%, previously at 26%)
and for cases of nonreassuring fetal status (64%).
We are committed to continuing to monitor and re-
¢ne this project as needed to meet our goal.
Another Set of Eyes: Remote Fetal
Monitoring Surveillance Aids the Busy
Labor and Delivery Unit
Poster Presentation
Remember those days on labor and delivery
when patients were coming out of the walls?
Often it was a struggle to take a bathroom break
much less take a lunch break.Wouldn’t it have been
great to have another nurse there to watch your fe-
tal monitoring strip for 1minute? This is exactly what
ANGELS at the University of Arkansas for Medical
Sciences did for their nurses on labor and delivery.
The innovative new program is called ANGELShield.
ANGEL Shield is housed in the ANGELS Call Center
which provides 24/7 phone consultation, triage,
and transport facilitation to providers and patients
throughout Arkansas. A section of the call center
houses a computer with multiple screens where the
fetal monitoring tracings from labor and delivery are
transmitted. Experienced labor and delivery nurses
remotely monitor the fetal monitoring tracings. Pro-
tocols were developed collaboratively between the
nurses on labor and delivery and the ANGEL Shield
nurses. The protocols specify when the ANGEL
Shield nurse is to contact the nurse on laborand de-
livery and who to call when the nurse is unavailable.
As with any program, there are growing pains. The
protocols are revised and improved as the program
develops. ANGEL Shield plans to expand its pro-
gram out to rural hospitals and providers. In small
town Arkansas, often there are only two labor and
delivery nurses on a unit at a time. They must man-
age all of the care for the patients on labor and
delivery and postpartum. The ANGEL Shield pro-
gram can provide them the support they need in
emergent situations. ANGEL Shield helps watch
the back of busy labor and delivery nurses.
Donna Williams, ADN, RN,
ANGELS Program, University
of Arkansas for Medical Sci-
ences, Little Rock, AR
Tesa Ivey, MSN, Maternal/
Infant Division, University of
Arkansas for Medical
Sciences, Little Rock, AR
Tina Benton, BSN, RN,
ANGELS Program, University
of Arkansas for Medical
Sciences, Little Rock, AR
Sarah Rhoads, DNP, APN,
ANGELS Program and the
College of Nursing, University
of Arkansas for Medical
Sciences, Little Rock, AR
Childbearing
JOGNN 2010; Vol. 39, Supplement 1 S41
Williams, D., Ivey, T., Benton, T. and Rhoads, S. I N N O V A T I V E P R O G R A M S
Proceedings of the 2010 AWHONN Annual Convention