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Planning Your First Steps Forward

Each site will proceed in its own way.

  • This is a two-year initiative. Begin today.
  • Think in terms of the topic areas below, and coordinate with your existing programs and projects.
  • Assign topics to leaders with specific strategies to achieve them.
  • Establish a timeline and stick to it.
  • Contact us for site visits, advice and resources.
  • The goal after two years is that each site will have its own sustainable obstetrics safety program.
  • For each topic area, design projects by answering two questions. These answers will vary from site to site.
    • What will have the most impact?
    • Do you have the power to make the change?

Topic areas

  • Communication to reduce error (SBAR, chain of communication, cesarean section urgency)
  • Clinical guidelines in accordance with national and regional standards that comply with regulatory requirements, established by a multi-disciplinary group
  • Quality assurance process that closes the loop with staff and informs policy making
  • Document templates such as admission labor note, brief intrapartum note, delivery note, shoulder dystocia note, vacuum delivery, forceps delivery, cesarean section note, placenta description in all notes
  • Obstetric RN orientation that provides adequate education and training, incorporates patient safety measures and is consistent from site to site
  • Drills and Simulations (PPH, shoulder dystocia, maternal seizure, stat cesarean section, unanticipated breech)
  • Credentials / Privileges as a patient safety tool
  • Terminology consistent across disciplines and departments (NICHD EFM, ACOG Committee Opinion #197, ACOG Practice Bulletin #33)
  • Professional associations to reduce isolation and stay current in practice (AWHONN, ACNM, ACOG, AAFP, NNEPQIN, Perinatal Nurse Managers)

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