Maternal mortality, or the death of a woman during pregnancy, at birth,
or soon after birth, has been on the rise in the United States since the
1990s. Data suggest that over 50% of these deaths are preventable. One
prevention strategy is the development and implementation of written
protocols for obstetric emergency situations.
In “Developing Protocols for Obstetric Emergencies,” Cheryl K. Roth,
PhD, WHNP-BC, RNC-OB, RNFA; Sheryl E. Parfitt, MSN, RNC-OB; Sandra L.
Herring, MSN, RNC-OB, CPHIMS; and Sarah A. Dent, MSN, RNC-OB, wrote
about creating and practicing clear protocols for obstetric emergencies
to be used by healthcare providers when responding to a pregnancy health
crisis. This article appears in the October/November 2014 issue of Nursing
for Women’s Health, the clinical practice journal of the Association
of Women’s Health, Obstetric and Neonatal Nurses (AWHONN).
The article details how a multidisciplinary, collaborative team at a
large community hospital developed and practiced obstetric emergency
protocols. The team started with a protocol for postpartum hemorrhage
developed by the California Maternal Quality Care Collaborative (CMQCC)
that is comprehensive and available as a checklist, flowchart or table
chart. These charts set the standard for the team to create one-page
protocols for the hospital to customize and adopt.
Following positive response to the postpartum hemorrhage protocol, the
team also developed protocols for common maternal health crises
including maternal code, shoulder dystocia, emergency cesarean, and
eclamptic seizure. Each protocol has color columns for every stage of
the emergency event and is divided into duties for nurses, physicians
and laboratory personnel.
“When unexpected crises occur on the OB unit, nurses and other
clinicians must act quickly and take appropriate steps to ensure best
health outcomes. Use of protocols during mock emergency drills can
assist in educating staff on critical steps,” wrote the authors. “In the
event these drills become reality, preparation that has occurred through
use of these protocols can promote a controlled atmosphere with optimal
results for both the women experiencing a health crisis and the health
care staff caring for them.”
“The development of detailed protocols to treat obstetric emergencies
will help prepare staff with the aim of reducing maternal mortalities,”
said AWHONN’s CEO, Lynn Erdman, MN, RN, FAAN. “By practicing the
protocols, the responding team will be prepared and ready for common
obstetric emergencies.”
AWHONN
Kelly Mack, 202-296-2002
krm@ecius.net