A new series of articles can be used to expand the current knowledge about patient safety in perinatal settings with a special emphasis on insights from nurses. This latest In Focus series, Patient Safety and Quality of Care, appears in the September/October 2013 issue of the Journal of Obstetric, Gynecologic, & Neonatal Nursing (JOGNN), published by the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN). The authors of the articles in the series investigate informed decision making during maternity care, underwater birth, emergency room triage for pregnant women, and communication of healthcare providers during treatment.
In “Nurses’ Perspectives on the Intersection of Safety and Informed Decision Making in Maternity Care,” Carrie H. Jacobson, RN, CNM, MS; Marya G. Zlatnik, MD, MSS; Holly Powell Kennedy, PhD, CNM, FACNM, FAAN; and Audrey Lyndon, PhD, RNC, CNS-BC, FAAN observed and interviewed maternity nurses at four hospitals to explore their perceptions about patients’ informed decision making during labor and how provider communication challenges may affect patient safety. While nurses feel informed consent is an important practice for patient safety, the authors advise that effective communication between nurses, doctors and administrators achieves the best outcomes for patients.
In the second article, “Implications for Patient Safety Regarding Underwater Birth,” Kathleen Rice Simpson, PhD, RNC, FAAN examines studies of water immersion birth and reviews guidelines from professional organizations on safety and precautions for this practice. Findings indicate few benefits of underwater births for mothers and none for infants; in some cases neonatal harm has been reported. The author recommends further research on this topic to determine safety.
In “The Importance of Interdepartmental Collaboration and Safe Triage for Pregnant Women in the Emergency Department,” Brenda Chagolla, RN, MSN, CNS; John P. Keats, MD; and Janet M. Fulton, PhD, MPA, RNC-OB review literature about the care of pregnant women in emergency departments and suggest a model for improving triage and evaluation. The authors recommend that emergency departments create policies for fast triage of pregnant women, including identifying them, determining gestational age, and flagging specific complaints for obstetric consultation.
In the final article, “The Effect of Collaboration on Obstetric Patient Safety in Three Academic Facilities,” Cheryl A. Raab, BSN, RNC-OB, C-EFM; Susan E. Brown Will, MS, RNC; Stacey L. Richards, MA, RNC-OB; and Elizabeth O’Mara, BSN examine interprofessional collaboration and communication and the potential effects on health outcomes for mothers, infants, and families. While more research is needed to compare communication practices with obstetric outcomes, the authors suggest the quality of provider team collaborations can influence patient safety practices.
“The actions of nurses, including practices and communications, have significant effects on patient outcomes,” said AWHONN’s CEO Karen Peddicord, PhD, RN. “Health care provider communication is a key element in safer care for patients as many of these articles point out.”
