Maternal mortality, at birth, or soon after birth, has been on the rise in the U.S. since the 1990s, according to the Centers for Disease Control and Prevention. Data suggest that more than 50% of these deaths are preventable (Berg et al., 2005; California Department of Public Health, 2011; Clark et al., 2008; Della Torre, et al., 2011; Geller et al., 2004), according to a Association of Womens Health, Obstetric and Neonatal Nurses news release.
One prevention strategy is the development and implementation of written protocols for obstetric emergency situations, which are now available thanks to four nurses with Scottsdale (Ariz.) Healthcare,
In Developing Protocols for Obstetric Emergencies, Cheryl K. Roth, PhD, WHNP-BC, RNC-OB, RNFA; Sheryl E. Parfitt, MSN, RNC-OB; Sandra L. Herring, MSN, RNC-OB, CPHIMS and Sarah A. Dent, MSN, RNC-OB, wrote about creating and practicing clear protocols for obstetric emergencies to be used by healthcare providers when responding to a maternal health crisis during pregnancy. This article appears in the October/November 2014 issue of Nursing for Womens Health, the AWHONN clinical practice journal. The article details how a multidisciplinary, collaborative team at a large community hospital developed and practiced obstetric emergency protocols. The team started with a protocol for postpartum hemorrhage developed by the California Maternal Quality Care Collaborative that is comprehensive and available as a checklist, flowchart or table chart. These charts set the standard for the team to create one-page protocols for the hospital to customize and adopt.
Following positive response to the postpartum hemorrhage protocol, the team also developed protocols for common maternal health crises including maternal code, shoulder dystocia, emergency cesarean and eclamptic seizure. Each protocol has color columns for every stage of the emergency event and is divided into duties for nurses, physicians and laboratory personnel.
When unexpected crises occur on the obstetric unit, nurses and other clinicians must act quickly and take appropriate steps to ensure best health outcomes. Use of protocols during mock emergency drills can assist in educating staff on critical steps, the authors wrote. In the event these drills become reality, preparation that has occurred through use of these protocols can promote a controlled atmosphere with optimal results for both the women experiencing a health crisis and the healthcare staff caring for them.
The development of detailed protocols to treat obstetric emergencies will help prepare staff with the aim of reducing maternal mortalities, AWHONNs CEO, Lynn Erdman, MN, RN, FAAN, said in a news release. By practicing the protocols, the responding team will be prepared and ready for common obstetric emergencies.
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