A Multidisciplinary Approach to Bringing the Obstetric Emergency Team Together

Abstract

<h2>Poster Presentation</h2><h3>Purpose for the Program</h3> Current evidence indicates that maternal mortality rates are increasing. The purpose of this project was to initiate a program that would improve multidisciplinary communication, increase efficiency, decrease staff confusion, and improve patient outcomes during an obstetric emergency. <h3>Proposed Change</h3> To quickly bring the integral maternal‐child personnel together in order to address the obstetric emergency, three separate unique codes (code Neo [neonatology], code OB [obstetric], and code L&D [labor and delivery]) were developed. The current practice was to individually call each physician, registered nurse (RN), technician, or ancillary staff member needed in the event of an obstetric emergency. This amounted to seven or more separate phone calls and could take several minutes; time was potentially taken away from intervening and treating a patient in an emergent situation. <h3>Implementation, Outcomes, and Evaluation</h3> Implementation involved collaboration and coordination with several departments along with educating staff and physicians about the benefits of having OB specific code teams. A policy was written to specifically describe each code: Code Neo, an emergency involving the resuscitation of a neonate; Code OB, a emergent postpartum hemorrhage or ecliptic seizure; Code L&D, a crash cesarean. The new policy outlined the different roles of each team member and identified who was required to respond to each code. The Code Neo, Code OB, and Code L&D concept was presented at physician department meetings. A Mock Code Committee was developed involving RNs, physicians, and several ancillary departments. Maternal/child staff was educated, mock codes were performed, and a date was set for implementation. Pagers were distributed to everyone on the code teams. During implementation, meetings were continued to discuss and resolve issues and to promote full adoption. A survey was conducted to assess the maternal/child staff's ability to handle an emergency situation preimplementation and postimplementation. Between October 2013 (implementation) and August 15, 2014, a total of 27 mock codes had been completed and staff had responded to 39 obstetric emergencies. As a result of the program's implementation, response time during an obstetric emergency decreased significantly and team members have become more comfortable in their roles. Positive feedback also was obtained from the postimplementation staff survey. <h3>Implications for Nursing Practice</h3> Only one phone call is now needed to activate the OB emergency team. Implementation of this program has resulted in increased multidisciplinary communication, increased staff confidence, and improved patient outcomes.