Other Titles

Being Aware of Cultural Differences in the Clinical Setting [Session]

Abstract

Session presented on Monday, November 9, 2015: "Changing Hospital Culture: Collaborative Response to Emergency Cesarean Sections" Problem: Based upon the American College of Obstetrics and Gynecology's (ACOG) and the American Academy of Pediatrics (AAP) recommended standard (30 minutes from decision to incision for emergency cesarean sections) the "30-minute rule," a preliminary data review of "decision to incision" time audits, identified discrepancies in standardized communication and collaboration between medical and nursing staff. Purpose: This four part educational program aimed to change the culture and create an effective and collaborative response to emergency cesarean sections: I-NICHD Nomenclature: Speaking a Common Language When Interpreting Fetal Heart Rate Tracings II-Concepts for Teamwork Training in Obstetrics Background and Significance III-Neonatal Outcomes IV-Potential Postpartum Outcomes Development/ Program Implementation. By integrating Kurt Lewin's "Change Management Model," this educational program's aim was to change the culture and create an effective and collaborative response to emergency cesarean sections. The methodology of this interprofessional program incorporated a broad range of instruction (didactic lecture, fetal strip review & simulation). Focus was on standardized communication, interprofessional teamwork training, potential maternal/ infant outcomes and simulation of emergency cesarean section scenarios. Evaluation/Results/Barriers: Through implementation of this four part educational program, in conjunction with the development of departmental guidelines, ongoing data collection, and quality improvement review, this program was able to facilitate and sustain effective inter-professional collaboration and has made a significant impact on compliance with the ACOG "30-minute rule" standard, see (Table 1) Decision to Incision Data Barriers to sustained culture change continue to be identified through the debriefing of each individual case and addressed through the provider and nurse "peer review process." Compliance with Standardized Nomenclature for Fetal Monitoring (NICHD language) Teamwork Following ER C/S Guidelines RN, Physician & Anesthesia Delays Improving patient safety and quality of care was the primary focus of the project. (Table 1) *2013-2014 Decision to Incision Data Cases which met the "30-min. Rule" standard ACOG Benchmark (% Compliance) *March 2013-December 2014 data, reflect post education results 1st quarter 2013-45% compliance *2nd quarter 2013-72% compliance 3rd quarter 2013-38% compliance 4th quarter 2013-89% compliance 1st quarter 2014-89% compliance 2nd quarter 2014-85% compliance 3rd quarter 2014-92% compliance 4th quarter 2014-62% compliance

Description

43rd Biennial Convention 2015 Theme: Serve Locally, Transform Regionally, Lead Globally.`

Author Details

Barbara C. Schuch, MSN, RNC-OB, C-EFM; Sally M. Krempel, RNC-OB

Sigma Membership

Epsilon Upsilon

Type

Presentation

Format Type

Text-based Document

Study Design/Type

N/A

Research Approach

N/A

Keywords:

Standardized Communication, Teamwork, Interdisciplinary Collaboration

Conference Name

43rd Biennial Convention

Conference Host

Sigma Theta Tau International

Conference Location

Las Vegas, Nevada, USA

Conference Year

2015

Rights Holder

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Proxy-submission

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Changing Hospital Culture: Collaborative Response to Emergency Cesarean Sections

Las Vegas, Nevada, USA

Session presented on Monday, November 9, 2015: "Changing Hospital Culture: Collaborative Response to Emergency Cesarean Sections" Problem: Based upon the American College of Obstetrics and Gynecology's (ACOG) and the American Academy of Pediatrics (AAP) recommended standard (30 minutes from decision to incision for emergency cesarean sections) the "30-minute rule," a preliminary data review of "decision to incision" time audits, identified discrepancies in standardized communication and collaboration between medical and nursing staff. Purpose: This four part educational program aimed to change the culture and create an effective and collaborative response to emergency cesarean sections: I-NICHD Nomenclature: Speaking a Common Language When Interpreting Fetal Heart Rate Tracings II-Concepts for Teamwork Training in Obstetrics Background and Significance III-Neonatal Outcomes IV-Potential Postpartum Outcomes Development/ Program Implementation. By integrating Kurt Lewin's "Change Management Model," this educational program's aim was to change the culture and create an effective and collaborative response to emergency cesarean sections. The methodology of this interprofessional program incorporated a broad range of instruction (didactic lecture, fetal strip review & simulation). Focus was on standardized communication, interprofessional teamwork training, potential maternal/ infant outcomes and simulation of emergency cesarean section scenarios. Evaluation/Results/Barriers: Through implementation of this four part educational program, in conjunction with the development of departmental guidelines, ongoing data collection, and quality improvement review, this program was able to facilitate and sustain effective inter-professional collaboration and has made a significant impact on compliance with the ACOG "30-minute rule" standard, see (Table 1) Decision to Incision Data Barriers to sustained culture change continue to be identified through the debriefing of each individual case and addressed through the provider and nurse "peer review process." Compliance with Standardized Nomenclature for Fetal Monitoring (NICHD language) Teamwork Following ER C/S Guidelines RN, Physician & Anesthesia Delays Improving patient safety and quality of care was the primary focus of the project. (Table 1) *2013-2014 Decision to Incision Data Cases which met the "30-min. Rule" standard ACOG Benchmark (% Compliance) *March 2013-December 2014 data, reflect post education results 1st quarter 2013-45% compliance *2nd quarter 2013-72% compliance 3rd quarter 2013-38% compliance 4th quarter 2013-89% compliance 1st quarter 2014-89% compliance 2nd quarter 2014-85% compliance 3rd quarter 2014-92% compliance 4th quarter 2014-62% compliance