Labor-Delivery-Recovery: A Case Study

I found you post interesting, and as to your question I have not seen, a facility that the nurses [OB] have such a huge responsibility. Labor room or birthing rooms on the unit yes but the other no “…a hospital which contain their own operating rooms, with each primary nurse serving the role of patient advocate, circulating nurse, scrub technician at times, PACU nurse along with being able to provide bedside care for their patients throughout labor”. It reminds me of a very similar situation in a facility where I was night supervisor where the “30 minuet rule for decision to incision” standard often occurred, and with less supporting staff,

Once the patients arrive to the unit, if the person belongs to either scheduled induction or C-Section, they are provided with a delivery room. If the patient does not belong to previously mentioned categories, and about to deliver, she is moved to a delivery room. One final category is, where patients come in because they feel that they are about to be in labor or the patients that experience various pregnancy related complications. These patients are monitored by the nurse, seen by the physician and put under observation. If any of those observation patients are about to go into labor, they will be moved to delivery room. The rest of the patients will be treated and discharged. A quick registration will be done for all patients as soon as they enter the unit. Additional documentation for triaged patients will be done after they are moved to triage. For patients in labor or C-Section, it will be done earliest of patient’s

Providing the best care to each patient starts with providing the proper amount of staff members to each unit. Looking at the needs of different units not only allows administration to see areas for improvement, but also areas that are being handled correctly. Utilizing the indicators provided by The Joint Commission, 4 East, a pediatric medical/surgical floor, has a high rate of falls and nosocomial pressure ulcers that appears to be related to the increase overtime nurses have been working for that floor (Nightingale, 2010). Research has shown increases in adverse events have been related to nurses working over 40 hours a week (Bae, 2012).

The author is a nurse in a level two trauma facility in a community of approximately fifty thousand people in Oregon. The community is a college-town surrounded by a large agricultural area. There is a minimal ethnic diversity within the community. The diversity present occurs mainly from internationally students and faculty from the college. There is a growing population of women who desire low interventional births in the community. The author has worked on the labor and delivery unit of the hospital for the last 14 years. The hospital is the only one in the area to offer trial of labor services to women who have previously undergone a cesarean section. The unit on average experiences around 1000 deliveries annually.

Clinicians recognize risk factors assess, better diagnose and manage patients and reduce mortality rates. (Trenary, 2007)Describes how Banner Health Care System uses a system called eICU where patients are cared for by intensivists, experienced critical care nurses and health unit secretaries working from a remote location on the campus of Banner Desert Medical Centre. From this location care clinicians can see and hear six different units in five different hospitals .Their aim is to increase this added support to all ICU patients within their Banner Health Care System across the seven states in twenty different facilities. .Using the eICU system the ICU rooms are fitted with a camera, microphone and a speaker .The camera is activated when initiated by the bedside team when there is an alert received from the eICU system .There is no recording availability so the system is HIPAA compliant .This system adds an additional support to the nurse patient ration at bedside. A similar system is used in the Ob department to support the nurses and help to reduce complications during childbirth

The goal is to increase our HCAPHS scores. To achieve this goal, the unit will implement the Perinatal Quality Collaborative of North Carolina (PQCNC) survey “How’s your Baby” on the unit at discharge. This is an anonymous survey for parents developed by PQCNC to assess patient care and readiness for discharge. A committee of three to four nurses, as part of a green belt project to revamp the unit’s discharge process, will take charge of the “How’s your Baby” initiative for the unit. The discharge committee will make sure that information on “How’s your Baby” is in the discharge packets and provide follow up with families once the infant is discharged from the hospital. The committee will provide education on the “How’s your Baby” initiative during staff meeting and provide feedback for staff on the

Providing an effective care and support to the patient and for their babies during labour

Throughout most of the shift, my nurse preceptor and I were in the patient’s room either evaluating her and the fetus, performing exams, taking vital signs, administering medications and fluids, charting, or reading the fetal monitoring strips. We also kept in regular contact with the physician to keep him up to date on the patient’s status and to receive new orders. We also spent a lot of time talking to the patient, her mother, and her boyfriend. They were concerned for the status of the mother and the baby. We explained to them that both the mother and the baby’s heart rate was high and their goal was to decrease them both. In addition, my nurse preceptor explained how we were administering Tylenol and amoxicillin to reduce the fever and

Durning, (2010) tells how nurses are limited in giving quality care due to the number of patients they have on their shift. It also explains the huge difference in the task of caring for a post-partum mother and a patient recovering from a major trauma surgery. When nurses are too busy because they have too many patients to care for, they are more likely to overlook an important change in their patient. This will cause the patient to deteriorate unnecessarily and could potentially result in death (Durning 2010). “Nurses are the main surveillance system in hospitals” (Queensland Nurse, 2010, p.14). If they have too many patients to look after, something is more likely to be missed. There was a study done last year by Nursing Times, that showed the more nurses a hospital had per bed, resulted in fewer patient deaths, and actually lowered the patient’s length of stay (Queensland Nurse, 2010). The state of Victoria in Australia, like California actually has government mandated nurse-to-patient ratios. Since its implementation of the ratios 10 years ago, Victoria’s health system has been made considerably better. There is a safer environment for the patients, the workplace morale is better, and there are less complaints from the public about the quality of care they receive while hospitalized (Holmes, 2010).

Maternity Care and Delivery is a totally different situation that involves the health and well being of two patients, the mom and the baby. The procedures we code for would include the monitoring

Within Victoria there are multiple models of maternity care available to women. An initial discussion with the woman’s treating GP during the early stages of her pregnancy is critical in her decision-making about which model of care she will choose and this key discussion is essential in allowing a woman to make the first of many informed decisions throughout her pregnancy. According to a survey conducted by Stevens et al. (2010) only 43% of women felt ‘they were not supported to maintain up-to-date knowledge on models of care, and most reported that model of care referrals were influenced by whether women had private health insurance coverage.’ Many elements of these models of care differ: from location of care, degree of caregiver continuity, rates of intervention and maternal and infant health, outcomes access to medical procedure, and philosophical orientation such as natural or medical (Stevens, Thompson, Kruske, Watson, & Miller, 2014). According to the World Health Organization (1985) and Commonwealth of Australia (2008) there is a recognition that ‘85% of pregnant women are capable of giving birth safely with minimal intervention with the remaining 15% at potential risk of medical complications’ (McIntyre & Francis, 2012).

(Weinberg, Auerbach, & Shah, 2009) This may prove especially important as the assessment and care of critically ill children is particularly stressful for providers. Debriefing after the simulation experience also provides a time for reflection. Concepts taught in lecture become more tangible as a result of their application during the simulation. Simulation has the potential to enhance pediatric nursing education, improve patient safety and provide additional experiences when clinical sites are limited. The student has an opportunity to build and practice a pediatric skill set. (Bultas, 2011)

Physical safety is especially important for pregnant women, as there is an unborn baby in their womb. One way of keeping clients physically safe is after having blood taken, or injections given, to use sterile needles, and then only use them once and dispose of them straight away. This is so the client does not get infected; throwing the needle away will stop infection spreading and stop it from accidentally piercing someone else’s skin. Another way of keeping clients physically safe is, for example, if the floor is wet and slippery, either dry it up or put up a ‘wet floor’ sign. Otherwise, a pregnant lady could slip and injure herself or her baby. Also, an example is on higher floors, if the antenatal ward is on a high floor, windows should only open slightly. This is so nobody can fall out of the window and seriously injure themselves. Hygiene is also an important physical life quality factor, because if health professionals (or clients) have poor hygiene, diseases could be spread throughout the ward and hospital. Ways for the professionals to keep hygienic is washing and sanitising their hands before coming into contact with the client. This stops spreading diseases around and also stops infections going into the client if they are using needles or syringes. For the clients to keep hygienic there are hand sanitizers in the ward for them to use. Also, on every floor there are

A Swedish midwife who was fired from three hospitals for her refusal to participate in abortion and lost a two-year legal battle to seek exemption from the procedure has decided to elevate her case to the European Court of Human Rights.

Visit your local Emergency Room on any given day and you are likely to witness a sort of controlled chaos: nurses, doctors, transporters, patient care technicians, and other ancillary staff members all darting about, attempting to meet the needs of increasingly sick patients in oft-overwhelmed and overpopulated hospitals. All around, various alarms sound. IV pumps signal fluid bags about to run dry. Vital sign monitors ping at differing volumes and intensities, in an electronic demand for staff to mind the out-of-normal-range