jueves, 16 de febrero de 2017

Changing Labor and Delivery Practice: Focus on Achieving Practice and Documentation Standardization with the Goal of Improving Neonatal Outcomes. - PubMed - NCBI

Changing Labor and Delivery Practice: Focus on Achieving Practice and Documentation Standardization with the Goal of Improving Neonatal Outcomes. - PubMed - NCBI



 2016 Dec;51 Suppl 3:2472-2486. doi: 10.1111/1475-6773.12589. Epub 2016 Oct 21.

Changing Labor and Delivery Practice: Focus on Achieving Practice and Documentation Standardization with the Goal of Improving Neonatal Outcomes.

Abstract

OBJECTIVE:

To establish multifactorial shoulder dystocia response and management protocol to promote sustainable practice change.

DATA SOURCES/STUDY SETTING:

Primary data collection was conducted over 3 years. Implementation of the protocol spanned 13 months. Data collection occurred at five sites, which were chosen for their diversity in both patient mix and geographical location.

STUDY DESIGN:

Case study evaluation methodology was used to examine clinician engagement and protocol adoption.

DATA COLLECTION METHODS:

The training completion for all practice engagement team activities was collected by the site project manager and entered into a flat file. Data from the labor and delivery notes, medical records, and interviews with labor and delivery teams were gathered and analyzed by the senior investigator.

PRINCIPAL FINDINGS:

In the first year, there was a threefold increase in shoulder dystocia reporting, which continued in years 2 and 3. In the first year, 96 percent of clinicians completed all training elements and in subsequent years, 98 percent completed the follow-up training. Overall teams reached a 99 percent adoption rate of the shoulder dystocia protocol.

CONCLUSIONS:

System and site management teams implemented a standardized shoulder dystocia protocol that fostered effective teamwork and obstetric team readiness for managing shoulder dystocia emergencies.

KEYWORDS:

Shoulder dystocia; adherence; guidelines

PMID:
 
27766653
 
PMCID:
 
PMC5134346
 [Available on 2017-12-01]
 
DOI:
 
10.1111/1475-6773.12589

[PubMed - in process]

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