OB Hemorrhage : A Collaborative Approach to Standardization
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Transcript of OB Hemorrhage : A Collaborative Approach to Standardization
OB Hemorrhage:A Collaborative Approach to Standardization
Presented by:Kristi McClure, RN, MSN, C-EFMClinical Educator, MCWJune 26, 2014
Mount Carmel Health System
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MCHS OB Collaborative
The Collaborative Approach
• Who–Multidisciplinary team–Physician champions
The Standardization Process
• What –The equipment–The process–The team–The documentation
The Standardization Process
• Where–Hospital–Health System–Region/State–Nation
But WHY?•Aviation•ACOG•AWHONN
How do We Start? (Project Planning)
• Regular monthly meetings• Leadership buy-in• Budget planning• Timeline/scheduling• Physician Engagement
Project Components
• Education Program • OB Hemorrhage policy• Rapid Response Team• Massive Transfusion Protocol• Written review process (Peer Review)• Written process for weighing blood soaked
items when hemorrhage identified
Accomplishments
Equipment - OB Hemorrhage Cart
Policy Development
• Policy written to include:– Risk assessment of all patients– Weighing all materials for accurate EBL– Staging of hemorrhage based on EBL– Reference to Massive Transfusion Policy*
OB Alert
OB Alert
Trinity OB Hemorrhage Education PlanEducation Requirements Responsible Persons Time Requirement per
ParticipantApprox. Number of MCSA
Participants
HealthStream Online Pre-Test(Nov 1, 2013 – Mar 31, 2014)
Required:•Nurses (L&D, MIU, RRT)•Physicians (Residents, Employed, Independent)•CNMsEncouraged: Anesthesia Providers
30 minutes Nurses = 190Physicians = 113CNMs = 15Anesthesia = 21
Recommended Readings &HealthStream Online Didactic Lecture(Nov 1, 2013 – Mar 31, 2014)
Required:•Nurses (L&D, MIU, RRT)•Physicians (Residents, Employed, Independent)•CNMsEncouraged: Anesthesia Providers
90 minutes Nurses = 190Physicians = 113CNMs = 15Anesthesia = 21
OB Hemorrhage Skill Stations(Apr 30, 2014 – Sept 30, 2015)
Required:•Nurses (L&D, MIU, RRT)•Physicians (Residents, Employed, Independent)•CNMs•OBT, MST, PCAEncouraged: Anesthesia Providers
30 minutes Nurses = 190Physicians = 113CNMs = 15Anesthesia = 21OBT, MST, PCA = 38
HealthStream Online TeamSTEPPS Lesson(Apr 30, 2014 - Sept 30, 2015) (Must be completed before simulation)
Required:•Nurses (L&D, MIU, RRT)•Physicians (Residents, Employed, Independent)•CNMs•OBT, MST, PCA•Unit CoordinatorsEncouraged: Anesthesia Providers
30 minutes Nurses = 190Physicians = 113CNMs = 15Anesthesia = 21OBT, MST, PCA = 38 Unit Coordinators = 17
Simulation & Debriefing(Apr 30, 2014 – Sept 30, 2015)
Required:•Nurses (L&D, MIU, RRT)•Physicians (Residents, Employed, Independent)•CNMs•OBT, MST, PCA•Unit CoordinatorsEncouraged: Anesthesia Providers
90 minutes Nurses = 190Physicians = 113CNMs = 15Anesthesia = 21OBT, MST, PCA = 38Unit Coordinators = 17
HealthStream Online Post-test(complete 3-6 month after simulation/debriefing– no later than Mar 31, 2016) – Must achieve a score of 80%
Required:•Nurses (L&D, MIU, RRT)•Physicians (Residents, Employed, Independent)•CNMsEncouraged: Anesthesia Providers
30 minutes Nurses = 190Physicians = 113CNMs = 15Anesthesia = 21
TOTALS 5 hrsover 2 ½ years
Total Time: 1,824 hrsover 2 ½ years
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Skills Stations
Simulation
Documentation
Documentation
Ultimate Goal