A Performance Improvement Process to Tackle Tachysystole
Summa Health System, Akron City Hospital, 525 East Market Med II, Akron, OH 44309, USA.Journal of Obstetric Gynecologic & Neonatal Nursing (Impact Factor: 1.02). 09/2011; 40(5):512-9. DOI: 10.1111/j.1552-6909.2011.01275.x
Inappropriate use of oxytocin is an important patient safety issue. In this article, the authors describe success in "tackling tachysystole" using an evidence-based algorithm for oxytocin administration. Monthly audits (N = 1160) reached 100% compliance. An algorithm posted at the bedside, multidisciplinary follow-up, education, and widely disseminated results helped counter resistance and normalization of deviance. Clinicians need standardized definitions and guidelines with measures of progress to manage safety concerns such as tachysystole.
- [Show abstract] [Hide abstract]
ABSTRACT: Inappropriate elective inductions of labor put patients at increased risk of cesarean, neonatal morbidity, and elevated cost. A scheduling procedure and consent form were implemented to eliminate elective induction at less than 39 weeks gestation and align indications for induction with American College of Obstetricians and Gynecologists guidelines. In 25 of the 28 months following implementation of the new process, we achieved the goal of eliminating elective induction of labor at less than 39 weeks gestation.Journal of Obstetric Gynecologic & Neonatal Nursing 06/2012; 41(4):462-73. DOI:10.1111/j.1552-6909.2012.01380.x · 1.02 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: We describe a nurse peer-review process to improve late deceleration recognition and intervention on one labor and delivery unit. Monthly chart audits (n = 721) met the goal of 75% reviewer agreement after the 4th month of implementation and have been maintained to date. Nurses recognized for excellence were more likely to be certified, work day shift, or be a member of the Perinatal Safety Team. Institutional support, a dedicated review team, and education contributed to success.Journal of Obstetric Gynecologic & Neonatal Nursing 03/2013; 42(2):215-224. DOI:10.1111/1552-6909.12023 · 1.02 Impact Factor
Chapter: The Pediatric Upper Extremity[Show abstract] [Hide abstract]
ABSTRACT: The most common nerve injury in children is neonatal brachial plexus palsy (NBPP). NBPP is associated with significant upper extremity impairment and carries with it quality of life impact on the child as well as the entire family. The occurrence of NBPP in the United States is close to 1.5 per 1,000 live births. Thirty to forty percent of these children will suffer permanent upper extremity functional insufficiencies. NBPP is not a new finding. In the mid-1700s, a physician named William Smellie wrote about a child that presented face-first for delivery. Smellie carefully delivered the child using forceps and noted that the long time spent in the birth canal had rendered the child’s arms paralyzed for several days. By the mid-1800s, NBPP had become known as obstetrical palsy, relating the palsy to delivery. In the late 1800s, a physician named Wilhelm Heinrich Erb posed a significant breakthrough when he described the C5–C6 junction as a common area of injury for NBPP patients. This chapter reviews what might be accepted as the high points of the history and epidemiology of NBPP. Understanding the past allows us to appreciate where we are in the present, and it gives us greater ability to focus on the future. Great strides have been made in just the last decade. There have been significant advances made in virtually all facets of this injury, understanding its incidence and risk factors, basic science insight to bone and muscle growth abnormalities following nerve injury, as well as both primary and secondary surgical reconstructive treatment approaches. The multidimensional physical and psychological challenges of this patient population will continue to merit coordinated multispecialty care for some time to come.The Pediatric Upper Extremity, 01/2015: pages 589-605; , ISBN: 978-1-4614-8513-1
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.