2011
Care bundles or best practices to emergency birth situations have recently proven to decrease birth injury and death according to recent medical information. This is good news for expecting families. Every year the majority of medical malpractice claims are filed for obstetric care and almost 91 percent of obstetricians and gynecologists have had a claim filed against them according to the American College of Obstetricians and Gynecologists.
Studies have shown that there are five major issues that cause problems during delivery. The first is failure to initiate a timely Cesarean section. The second issue is the failure to recognize a baby in distress. The third issue is the failure to properly resuscitate a baby. The fourth is an inappropriate use of labor-inducing drugs, and the final major issue is the misuse of vacuums and forceps. Often, injuries occur when delivery teams do not act fast enough in handling an unexpected emergency.
The federal Agency for Healthcare Research and Quality has awarded grants to hospitals in order to improve obstetrics safety. Among the developments is care bundles, which are a series of protocols produced out of best practices that work better than one individual action. For example, during vacuum-assisted birth, babies can suffer scalp lacerations and hemorrhages. A safety feature of the vacuum is its suction cup will pop off if the angle is inappropriate or if there is too much traction. However, there is no clear rule when the suction has come off too many times or when the procedure should be discontinued.
In the care bundle for the procedure physicians and nurses share a series of steps. They discuss the risk, benefits and alternatives of the procedure with the patient. The conversation is documented and the patient is reviewed to determine the success of the procedure. The best practice also specifies the number of times the suction cup may pop off and the length of time the procedure should be attempted. It also provides a backup plan.
Care bundles have improved birth injuries and birth death rates by 50 percent at Ascension Health, the St. Louis based hospital system that started its obstetrics-safety program in 2003.
Source: The Wall Street Journal, "Delivering results," Laura Landro, 3/28/11
Tags: best practices, birth injuries, care bundles, emergency birth, obstetricsComments: Leave a commentView the Original article