I Have An OB Emergency -- Call the OB Emergency Team STAT

  Purpose for the program: Planning for obstetrical emergencies is an integral part of the function of every obstetric service and can be categorized as fetal or maternal in nature.  At this time there are limited data correlating the timing of intervention with outcome.  However, in general, the consensus has been the capability of beginning a cesarean delivery within 30 minutes of the decision to operate.  Some indications for cesarean delivery can be appropriately accommodated in longer than 30 minutes according to the American College of Obstetricians and gynecologists (ACOG).  Maternal emergencies are indirectly linked to the fetal outcome as well.

  Proposed change: Initially a small team was put together to look at the response rate to obstetrical emergencies on our unit.  We identified a physician champion and together with the team presented our findings.  Prior to the initiation of the OBET, when an emergency occurred the nurse called for help and then there was frantic moments calling physicians to respond to the bedside.  The OBET was developed to be available with one phone call.  Any staff member may activate the OBET.

 Implementation, outcomes and evaluation: Prior to the implementation of the OBET an educational session was held to create an awareness of indications to activate the OBET.  To ensure the staff were comfortable with the use of the OBET we held simulation drills using a high end fidelity simulator.  The simulator was admitted to the hospital as a normal pregnant patient.  The nurse took report and provided care and one point the patient decompensated.  The nurse had to recognize the decompensation and call for help using the OBET process.  It is important to consider what the name of your team.  When we first implemented the OBET it was initially called the Perinatal Rapid Response Team.  There were times when we called the Perinatal Rapid Response Team and the Emergency Call Center sent us the Hospital Rapid Response Team.  We are  currently reviewing the OBET calls to evaluate the effectiveness of the OBET and the process.

 Implications for nursing practice: Implementing an OB Emergency Team has empowered the perinatal nurse as they are able to activate the OBET when they feel their patient is experiencing an obstetrical emergency and they need help stat.  Using simulation to educate the team is bringing us towards a more functional team.

 Keywords: OB Emergency, OB STAT, simulation