The Different Types Of Obstetric Emergencies Discussion

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The Different Types Of Obstetric Emergencies Discussion

Background

Different types of obstetric emergencies can occur at any time during labor. Some of these emergencies can be serious and fatal. Some can result in complications that may affect the mother both in the long and short term. To curb these possible complications and manage the emergencies effectively, it is vital to ensure that emergency trolleys are always fully stocked with the necessary emergency rescue drugs, fluids, and equipment. Sierra Leone is one of the world’s countries with high maternal mortality rates, with a maternal mortality ratio of 510 deaths per 100,000 live births (Carson-Marsh et al., 2022)The Different Types Of Obstetric Emergencies Discussion . The major causes of these deaths are hemorrhage followed by eclampsia and sepsis. Nurses should be charged with ensuring that emergency trolleys are fully stocked daily, checking the contents onto the Emergency Trolley Contents and Layout Checklist. The checklist should be audited at regular intervals to ensure adherence to the minimum daily checklist requirements.

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Impact Statement

This capstone project aims to examine the importance of maintaining a well-stocked obstetric emergency trolley in the labor and delivery unit. This will ensure swift response to the emergency situations in the unit, enhancing quality service provision and promoting emergency response and resuscitation for both the mother and the newborn.

Project Purpose and objectives

The purpose of this project is to assess and evaluate the state of the trolley for emergency response and examine the importance of having all the emergency response drugs and equipment in the emergency response trolley. The objectives include evaluating the availability of the essential emergency response equipment, evaluating the availability of the essential emergency response resuscitation drugs, and assessing the condition and functionality of the emergency response trolley The Different Types Of Obstetric Emergencies Discussion .

Project Design and Implementation

This project aims at ensuring the safety of obstetrics patients during the process of labor by ensuring that emergency trays are well stocked and functional for effective resuscitation and prompt response to obstetrics emergencies. A team of nurses and midwives will be at the forefront in helping implement this project plan. My role as the project manager will be to oversee the project, ensuring the availability of resources and that all goals are met. Resources needed to ensure that the project is adequately carried out include trained personnel, emergency response equipment and drugs to be stocked in the emergency trolleys, and an approved evidence-based protocol for handling the trolleys. The project will involve the implementation of drills, simulations, and training for nurses and midwives to ensure proper protocols are followed in handling the emergency trolley and that they are knowledgeable about the contents of an emergency tray. Studies have shown that implementing skills and drills in emergency obstetrics care significantly reduces maternal and neonatal deaths (Pattinson et al.,2019)The Different Types Of Obstetric Emergencies Discussion .

A crash cart supply and equipment checklist will be used to ensure all the required supplies are stocked in the emergency crash cart daily (Collier et al., 2019). Ensuring the crash cart is adequately stocked according to the protocols will lie solely on the nurses and midwives in the labor and delivery room. I will identify the team leaders with the knowledge and capacity to provide leadership during obstetric emergencies and debrief staff after the emergency response to identify the strengths, weaknesses, and opportunities for improvement. The completion of the project will provide a future blueprint for the necessity of stocking the obstetric emergency trolleys in the labor delivery room.

Expected Results

The result of the project is expected to bring about a change in midwives’ attitudes towards the use of the emergency trays, equipping them with evidence-based benefits of having a well-stocked emergency response trolley to enhance prompt and quicker response to obstetric emergencies by the end of December 2022. The results will be measured by evaluating the average emergency response time in cases where there is a well-stocked emergency trolley with appropriate handling protocols and noting the outcome of the patients.

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Work Plan

The work plan of a project guides the project execution and control. It outlines the project plan, the method for managing resources, and the necessary steps to execute and complete the task (Sipes, 2020)The Different Types Of Obstetric Emergencies Discussion . To ensure that the project proceeds in an orderly and effective manner, I will carry out a training and mentorship program for the staff on the components of an obstetrics emergency trolley, provide guidelines and protocols to be observed to ensure proper stocking of the trolley, and how to handle the stocked trolley (Manetti et al.,2018). After ensuring that the staff is knowledgeable in this area, I will allow them to work with the well-stocked emergency trolley and then evaluate the average response time for the emergencies and their outcomes, noting what was done right and identifying potential areas for improvement.

Estimated Timeline

The project will run for six months. During this period, the project manager will schedule each phase to fit into this estimated timeline.

References

Carson-Marsh, R., Aimone, A., Ansumana, R., Swaray, I. B., Assalif, A., Musa, A., … & Jha, P. (2022). Child, maternal, and adult mortality in Sierra Leone: nationally representative mortality survey 2018–20. The Lancet Global Health, 10(1), e114-e123. https://doi.org/10.1016/S2214-109X(21)00459-9

Pattinson, R. C., Bergh, A. M., Ameh, C., Makin, J., Pillay, Y., Van den Broek, N., & Moodley, J. (2019). Reducing maternal deaths by skills-and-drills training in managing obstetric emergencies: A before-and-after observational study. South African Medical Journal, 109(4), 241-245. http://dx.doi.org/10.7196/samj.2019.vl09i4.13578

Sipes, C. (2020). Project Management for the Advanced Practice Nurse (2nd Ed.). Springer

Collier, A. Y., & Molina, R. L. (2019). Maternal Mortality in the United States: Updates on Trends, Causes, and Solutions. NeoReviews, 20(10), e561–e574. https://doi.org/10.1542/neo.20-10-e561

Manetti, B. K. S., Amukugo, H. J., & Shilunga, A. P. (2018). Emergency trolley’s contents and records: audit study at maternity sections, State Hospitals, Windhoek, Namibia The Different Types Of Obstetric Emergencies Discussion .

Abstract

Obstetric emergencies in the maternity unit are almost a norm and can happen at any time. Over decades, maternal morbidity has continued to rise in Sierra Leone from complications of childbirth, intra-and-post-partum. The major obstetric emergencies are postpartum hemorrhage, eclampsia, and sepsis. With Partners In Health – Maternal Centre of Excellence (MCOE) in Sierra Leone, we expect more women and more referrals and hence the potential of having more complicated cases. It is therefore important to have measures in place to curb the menace by being prepared all the time. The first steps would be to have the unit prepare themselves by assessing potential emergencies, establishing early warning systems; Identifying team leads who have the knowledge and capacity to lead during emergencies, emergency drills, and debriefing staff after actual events to identify strengths and opportunities for improvement. A successful emergency response team would benefit greatly from having appropriate emergency supplies in the emergency trolley/crash cart, protocols on handling emergencies, and having a rapid response team that will include, constant implementation of drills and simulations.

Keywords: Obstetric emergencies, maternity, labor and delivery, emergency preparedness, train

Background

Many different types of obstetric emergencies can occur during labor. Obstetric emergencies can be very serious and can lead to both short- and long-term complications for the mother and baby. In Sierra Leone, maternal mortality is a major health concern, with a ratio of 510 deaths per 100 000 live births, and is among the highest rates in the world (Carshon-Marsh et al., 2022)The Different Types Of Obstetric Emergencies Discussion . According to the study, hemorrhage was the major cause of maternal mortality, followed by eclampsia and sepsis. Although our hospital has a competent nursing team and other care providers who can manage emergencies, morbidity and mortality from the emergencies are on the rise. It is unknown what continues to prevent full abatement of the poor outcomes. Thus, this capstone project seeks to intervene effectively to curb the development of obstetric emergencies and improve the outcomes of care in the labor and delivery room.

Impact Statement

The capstone project aims to provide emergency preparedness training focusing on the importance of being prepared in terms of manpower, supplies, and skills-wise. The expected outcome will be enhanced patient safety and the ability to mitigate adverse outcomes.

Project Objective

The objective of this project is to implement obstetric emergency preparedness in the labor and delivery unit and improve overall patient safety. The project will ensure that a well-prepared team is available to recognize early warning signs and activate emergency protocols promptly. If a success, the Maternity unit will adopt the project interventions at the antenatal and postnatal units.

PROJECT DESIGN AND IMPLEMENTATION

The goal of this phase is to ensure that all patients are safe since the care provider will be prepared for any emergency that may occur. During this phase, a team of midwives and clinicians will help implement the plan. As the project manager, my roles will include overseeing the project, ensuring the availability of the allocated resources, and ensuring all goals are met. Resources needed for the project include trained personnel, appropriate equipment, constant supplies in the emergency trolley/crash cart, and protocols on handling emergencies. The project will involve the constant implementation of drills and simulations, and training for midwives. According to Pattinson et al. (2019)The Different Types Of Obstetric Emergencies Discussion , implementing skills and drills on Emergency obstetric care (EmOC) training is significant in helping reduce maternal deaths. During this time, the team will use checklists and patient registers to investigate different ways to improve emergency preparedness. A focus will also be placed on ensuring that all stakeholders are aware of and involved in the project. The midwives will be responsible for implementing the emergency preparedness plan in the labor and delivery room. The team will train the midwives on how to be more prepared in case of an emergency by assessing potential emergencies and establishing early warning systems. As the project manager, I will help Identify team leads who have the knowledge and capacity to lead during emergencies, emergency drills, and debriefing staff after actual events to identify strengths and opportunities for improvement. Once the project is complete, it will provide a blueprint for future projects that aim to increase emergency preparedness in the labor and delivery room.

Expected Results

By December 2022, we hope to see always stocked emergency trolleys, protocols on emergency preparedness, and knowledgeable nurses and midwives. This will be measured by auditing the emergency cases by the time the emergency was noted to end, the use of protocol, and the situation outcome.

Work plan

The work plan outlines the project plan, resource management plan, and steps necessary to complete a project (Sipes, 2020)The Different Types Of Obstetric Emergencies Discussion . By establishing specific deadlines and outlining the tasks required to achieve them, the PM can ensure that the project proceeds in an orderly and effective manner. For this project, the project manager will conduct a training and mentorship program for the unit staff on triggers of emergencies proper monitoring of patients, and preparedness from May to July 2022. Next, the project manager will audit all emergency cases with the team involved and evaluate what was done right and what could improve to adjust and learn. Another task will be the performance of emergency drills to see if the team is well equipped in terms of skills and resources.

Estimated Timeline

The timeline for the project is six months within which the project is expected to be completed. At this time, the project manager will schedule each project phase to fit into estimated timeframes.

References

Ameh, C. A., Mdegela, M., White, S., & van den Broek, N. (2019). The effectiveness of training in emergency obstetric care: a systematic literature review. Health policy and planning, 34(4), 257-270. https://doi.org/10.1093/heapol/czz028

Collier, A. Y., & Molina, R. L. (2019). Maternal Mortality in the United States: Updates on Trends, Causes, and Solutions. NeoReviews, 20(10), e561–e574. https://doi.org/10.1542/neo.20-10-e561

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Sipes, C. (2020). Project Management For the Advanced Practice Nurse (2nd Ed.). Springer

improved overall patient safety

improved maternal and newborn outcomes

well-prepared team to recognize early warning signs and activate emergency protocols promptly The Different Types Of Obstetric Emergencies Discussion