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Labor-Delivery-Recovery: A Case Study

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The hospital involved is an urban facility, with an OB residency program and a certified nurse-midwife (CNM) practice, located in a downtown neighborhood. The hospital’s Women and Infants (W&I) department includes a 5-bed Triage unit; an 18-bed L&D unit with 3 OB operating rooms and 4 pre-operative/post-operative rooms; a Mother-Baby unit with 42 beds dedicated to mother and infant care; and a Neonatal Intensive Care Unit (NICU) with 35 Level III-B private rooms. The L&D unit Labor-Delivery-Recovery (LDR) rooms surround an internal caregiver station for the use of nurses, residents, and providers. The caregiver station has 18 computer stations, an electronic white board where team hand-offs occur, and 2 additional mounted large screens allowing for continual FHR tracing display of all monitored patients. Moreover, each individual computer in the caregiver …show more content…

Consequently, from their regular involvement in the skills training and simulation in this perinatal safety program, staff has learned the importance of teamwork and the concise communication of SBAR (situation-background-assessment- recommendation) in critical situations that can occur in the dynamic environments of any of the W&I clinical units. One CETT technique learned and practiced regularly in simulation trainings which is applied to real-time use on all W&I units is that of debriefing serious and near-serious events. Debriefs, conducted as closely as possible to the time of the critical event, have helped to identify trends over time and resulted in action items to improve processes and the delivery of safe patient care. One adverse trend identified from debriefs of neonatal code blue events in 2015 was an increase in the unforeseen number of term infants requiring resuscitations after delivery with admissions to the

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