Paper
Wednesday, 19 July 2006
This presentation is part of : Collaborative Teams Initiatives
When Lightening Strikes…We're Ready!!! Teams Performance and Communication During Eclamptic Seizures
Ana-Maria Gallo, PhD, CNS, RNC, Perinatal, Sharp Mary Birch Hospital for Women, San Diego, CA, USA, Suzanne Flohr-Rincon, BSN, RN, Labor & Delivery, Sharp Mary Birch Hospital for Women, San Diego, CA, USA, and Lindsey Anderson, RN, BSN, Labor and Delivery and Perinatal Special Care Unit, Sharp Mary Birch Hospital for Women, San Diego, CA, USA.
Learning Objective #1: Discuss how professional organizations are valuable resources to evidence-based information.
Learning Objective #2: List critical items that are essential to perform which result in positive maternal and fetal outcome.
Hypertension during pregnancy has been one of the leading causes of perinatal morbidity and mortality. In the U.S., approximately 5% of pregnancies are complicated by preeclampsia. Of these patients, 0.5-2% progress to eclamptic. Maternal complications of eclampsia may include permanent CNS damage from recurrent seizures or intracranial bleeds, renal insufficiency, and death. Causes of neonatal death include prematurity, placental infarcts, intrauterine growth retardation, abruptio placentae, and fetal hypoxia.
In late 2004, a series of eclamptic seizures occurred in the obstetrical units at Sharp Mary Birch Hospital for Women. In this emergent situation, the coordinated timely efforts of the team were questionable.  Concurrently, JCAHO announced a Sentinel Event Alert suggesting that the majority of perinatal death and injury cases were the result of problems with organizational culture and with communication among caregivers. It was recommended that organizations with high-risk events conduct clinical drills to help staff prepare for when such events actually occur, and conduct debriefings to evaluate team performance and identify areas for improvement.
An interdisciplinary team was formed to address this issue and to enhance care and communication among caregivers during an eclamptic seizure. The team developed an “Eclamptic Seizure Procedure” drill and medication algorithm based on current literature and AWHONN & ACCOG standards and established goals which made significant positive differences in the last year in staff education and patient safety related to the care of the eclamptic patient.
Evidence-based practice demonstrated that there are 38 critical tasks/items that staff must perform during eclamptic seizures which contribute to better outcomes for the mother and fetus.  Therefore, measurable outcomes consisted of the staff’s demonstration of critical tasks/items during the performance of eclamptic seizure drills.  The execution of this system/drill has thus resulted in a heightened understanding and demonstration of coordinated timely care of the eclamptic patient.

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See more of The 17th International Nursing Research Congress Focusing on Evidence-Based Practice (19-22 July 2006)