Development of a Tool to Measure Nurse Clinical Judgment During Maternal Mortality Case Review.

National task forces have been charged to reduce maternal mortality rates. To do so, they must identify the role of the nurse in accomplishing this goal, but the specific assessments and interventions for which only nurses are responsible have yet to be defined. Clinical judgment, which is the ability to notice, interpret, and respond to potential problems, is a core nurse function. Nurse clinical judgment can be evaluated during chart review with new available tools.

Pregnancy-associated mortality review: the Florida experience.

At the beginning of the 20th century, maternal mortality was a leading cause of death for women of reproductive age in the United States. Obstetrical care was not standardized, and there was a lack of universal systems for monitoring maternal deaths. Public health efforts of surveillance, along with advances in medicine and sanitation, resulted in a significant decrease in maternal deaths by the early 1980s. Today, maternal death is considered to be a rare event; however, the rates of maternal mortality have not improved in almost 3 decades. There is growing evidence that many maternal deaths can still be prevented through enhanced surveillance that influences improvements in overall health and delivery of care. This paper describes the experience of establishing and maintaining a pregnancy-associated mortality surveillance system in Florida. Emphasis is placed on the process and importance of a statewide review and the value of engagement with the medical community.