The Association of Women’s Health, Obstetric and Neonatal Nurses has developed a tool for an improved, standardized approach to triage for pregnant women who seek emergency or non-scheduled care. The Maternal Fetal Triage Index is informed by previous research, best practices and other successful models developed for use in the ED, according to a news release.
The MFTI includes specific descriptions of the signs and symptoms with which women may present during all trimesters of pregnancy. Based on these symptoms, nurses assign one of five acuity levels to the woman and/or fetus. A brief video with additional details on the MFTI tool is available on YouTube.
“There is a clear need for standardizing obstetric triage in clinical settings nationwide,” AWHONN CEO Lynn Erdman, MN, RN, FAAN, said in the release. “The Maternal Fetal Triage Index is a strong step forward in improving how nurses perform triage in the United States.”
Researchers explore obstetrics triage and describe the content validity and interrater reliability testing of the MFTI tool in three articles in the November/December 2015 issue of Journal of Obstetric, Gynecologic, & Neonatal Nursing.
In “Content Validity Testing of the Maternal Fetal Triage Index” Catherine Ruhl, MS, CNM; Benjamin Scheich, MS; Brea Onokpise, MPH, CHES; and Debra Bingham, DrPH, RN, FANN, describe the process by which the MFTI tool was validated by a multidisciplinary group of clinicians.
In “Interrater Reliability Testing of the Maternal Fetal Triage Index,” the authors compared blinded, paired triage assessments performed by nurses using the MFTI tool in a large suburban hospital. They found the priority levels assigned by the nurses were in agreement with the MFTI nurse researcher 72.9% of the time and that there was no significant difference in accuracy of assigning priority levels between the day and night shifts. The results of this research demonstrate that the MFTI tool can be recommended for use in obstetric triage settings, according to the release.
In “Women’s Satisfaction with Obstetric Triage Services,” Marilyn K. Evans, RN, PhD; Nancy Watts, RN, MN, PNC(C); and Robert Gratton, MD, conducted phone interviews with women after their discharge from a hospital’s obstetric triage unit. The research found that women’s satisfaction during triage increased when the team used a humanizing, caring approach. The women also appreciated being informed about their own well-being and the well-being of their fetuses.
To create an ongoing dialogue with hospital leaders, AWHONN has formed the MFTI Pilot Community, scheduled to launch in January. The goals of this community are to identify and assess the successes and challenges of educating obstetric nurses about triage and the MFTI; discuss challenges and obstacles to integrating the MFTI algorithm into the electronic medical record; and categorize best practices and barriers to implementation of the MFTI in labor and birth units.
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