Improving Safety Through Collaboration: The Interdisciplinary Perinatal Practice Committee

Purpose for the program:

Clinical care may not always be consistent with the latest evidence and scientific standards found in the peer reviewed scientific literature, professional organization standards, and regulatory agencies. Risk reduction strategies in perinatal practice include adopting professional organization guidelines, standardizing evaluation and monitoring processes, and communicating identifiable pregnancy risks to members of the healthcare team. Communication issues have been identified as a leading cause of sentinel events.  There was not an identifiable process to review the scientific literature, compare current practice to current scientific evidence, and recommend change based on the literature review.  

Proposed change:

We needed an opportunity to collaborate with nursing, medical providers, risk management, and administration to look at our processes and practice throughout the continuum of maternal/newborn care. The concept of the Interdisciplinary Perinatal Practice Committee (IPPC) was identified and applied to our setting (Simpson, Kortz, & Knox, 2009).

Implementation, outcomes and evaluation:

Discussions with key leaders in nursing, obstetrics, neonatology, and risk management were held to garner support of the idea.  The Perinatal Advanced Nurse Clinician attended OB/GYN staff meetings to further promote the idea and to assist with identification of providers who would co-chair the IPPC with nursing.  Informal nursing leaders/change agents were recruited to be part of the committee.

Since its inception, the IPPC has met regularly. Topics are chosen based on staff input, policies and procedures that are in need of being updated, and trends in evidence-based practice in the perinatal setting.  The first topic, which took three meetings to review, was the use of Oxytocin. Scientific, evidence-based articles and professional guidelines pertinent to the topic of discussion were sent to the committee members for review prior to each meeting.  Medical education credits and nursing contact hours were obtained for each meeting.  Each meeting has consisted of lively, collaborative, and respectful discussion. 

Nursing and medicine came together to look at the standards and evidence, compare current practice, and make changes to policies/procedures.  New EMR order sets were created based on the work of the IPPC. Order sets default to an increase of rate of Oxytocin every 30 minutes. Random audits of charts have shown that the providers are consistently using the new order sets.  This indicates the success of the work of the IPPC. 

Implications for nursing practice:

Regularly scheduled meetings will insure the continued work of the IPPC. This will serve to enhance patient safety as all disciplines involved are communicating using the same framework, collaborating, and integrating current science into practice.

Keywords: interdisciplinary perinatal committee; perinatal safety; collaboration