Sunday, Sep 26 - Expo Hall Opening
Sunday, Sep 26 - Job Fair
Monday,
Sep 27 - AWHONN's Block Party
Sunday, September 26, 2010
Title: Introducing a Standardized Oxytocin Dosing Protocol in a Multifacility Healthcare System
Discipline: Childbearing (CB)
Learning Objectives:
Submission Description:- List 3 components of a successful consensus implementation model
- Describe the components of a successful toolkit for education, implementation and compliance of a change in practice
- Identify strategies for “hard wiring” practice changes utilizing current technology
Reviewing research and identifying best practices is relatively easy. Implementing these best practices to achieve successful change and standardization is where the challenge lies. This large healthcare system has found a winning formula using science, technology and a passion to provide excellent patient care to standardize obstetrical practice to reduce risk and improve outcomes.
The process includes:
· Identify an area of concern
· Review the literature and data to identify best practice
· Consensus approval of a standardized protocol by a panel of physicians including perinatologists, obstetricians, family practice physicians; certified nurse midwives, bedside nurses with ad hoc participation from ancillary departments - pharmacy, anesthesia, risk management, etc.
· A toolkit for education to all clinicians utilizing various training methods including tip sheets and web based training with demonstrations
· Implementation of the protocol into an electronic medical record system with clinical decision support capability
· Harvesting outcome data from the electronic medical record
· Revision of the protocol as needed.
This process has been used for several changes including DVT prophylaxis, magnesium sulfate administration and postpartum depression screening. This poster presentation will demonstrate how this process is used to achieve standardization of oxytocin administration. Oxytocin is currently one of 16 drugs “black boxed” by the Food and Drug Administration due to the risk of adverse outcomes. Nevertheless, it is used in 33% of all women in labor.
A subcommittee reviewed the literature and proposed a protocol for oxytocin administration. This proposal was presented to the entire committee, discussed, revised and approved using the principles of consensus. A toolkit was developed for communication and education to nurses, physicians, and pharmacists. The new protocol was hard-wired utilizing the EMR. An order with preset defaults was built as well as prompts related to when the oxytocin should be turned off and when the physician should be notified.
Data will be presented indicating the incidents of uterine tachysystole prior to the implementation of this protocol as well as post implementation.
