The Art of Managing An Obstetrical Emergency: Code 2 Ballet
- Develop a strategic plan that enables all staff to collaborate during an obstetric emergency.
- Establish roles for each member of the health care team during the emergent procedure.
- Relate the process of managing an emergent situation to a variety of health care facilities or settings.
Proposed change: To change practice during obstetric emergencies whereby each particpant has a clearly delineated role and responsibility.
Implementation, outcomes and evaluation: Effective management of obstetric emergencies is critical to ensure positive maternal and neonatal outcomes. Concerns were expressed by staff members when such emergencies occured, citing such issues as unclear roles. Labor and Delivery Managers and staff RNs met with Anesthesia personnel to evaluate present practice during a "Code 2", or obstetric emergency. While improved patient outcomes was always the ultimate goal, gaps in practice were discussed and changes proposed. A literature review was conducted, and new information was shared among team menbers. The process was outlined based on findings from the literature, and clearly defined roles were developed. Staff members were educated, and the process was simulated with all team members present prior to implementation. The result was a much smoother "performance" when a Code 2 emergency occurred, evolving much like a ballet. Staff members expressed positive feedback, and continuous evaluation is on-going. The process wil continue to be simulated in required Skills Lab to ensure that staff remains cognizant of the procedure.
Implications for nursing practice: While this procedure was developed in a Labor and Delivery setting, the process can be easily applicable to a variety of clinical units. Improved patient outcomes will occur when each team member has clearly defined roles and expectations.
Keywords: Obstetric emergency, Labor and Delivery, Role Management
