Using Telemedicine to Provide Safe Care When Birth Occurs in the Emergency Department

Abstract

To provide safe, high-quality care to newborns and mothers who give birth in community emergency rooms without on-site labor and delivery services. To use telemedicine as a complementary strategy to enhance the delivery of safe care for women who give birth in the emergency room setting. Multidisciplinary meetings were held to identify educational needs, elicit recommendations for successful implementation of education, and voice concerns and potential solutions of organizational barriers. The educational plan included emergency delivery and initial newborn care basics and principals of neonatal resuscitation. Interdisciplinary and multidepartment emergency delivery simulation was successfully used to bring a real-time perspective to emergency room staff. The use of telemedicine enabled the clinical staff to obtain access to a specialist (obstetrics and neonatology) support network to help provide the best care for the mother–infant dyad. Another benefit to the use of telemedicine was a heightened level of comfort knowing that expert guidance of a specialist was just a call away. Outcomes of the program implementation included ensuring adequate equipment and user-friendly resources were available for emergency delivery. Session evaluation results were positive and additional sessions will be held on a routine basis. Nurses and physicians in emergency departments must possess a broad knowledge base in order to care for their very diverse population. Staff from labor and delivery and the NICU conversely possess very population-specific skills, which allow them to be experts in their fields. Working collaboratively through the use of telemedicine allows these specialties to merge knowledge and skills to provide exceptional care to the mother–infant dyad during these unplanned events.