RESUMO
Inappropriate elective inductions of labor put patients at increased risk of cesarean, neonatal morbidity, and elevated cost. A scheduling procedure and consent form were implemented to eliminate elective induction at less than 39 weeks gestation and align indications for induction with American College of Obstetricians and Gynecologists guidelines. In 25 of the 28 months following implementation of the new process, we achieved the goal of eliminating elective induction of labor at less than 39 weeks gestation.
Assuntos
Agendamento de Consultas , Controle de Formulários e Registros , Consentimento Livre e Esclarecido , Trabalho de Parto Induzido , Melhoria de Qualidade , Feminino , Idade Gestacional , Humanos , Meio-Oeste dos Estados Unidos , Gravidez , Desenvolvimento de Programas , Padrões de Referência , Gestão de Riscos , Procedimentos DesnecessáriosRESUMO
Inappropriate use of oxytocin is an important patient safety issue. In this article, the authors describe success in "tackling tachysystole" using an evidence-based algorithm for oxytocin administration. Monthly audits (N = 1160) reached 100% compliance. An algorithm posted at the bedside, multidisciplinary follow-up, education, and widely disseminated results helped counter resistance and normalization of deviance. Clinicians need standardized definitions and guidelines with measures of progress to manage safety concerns such as tachysystole.