The purpose of this quality improvement project is to implement a best practice obstetric rapid response team (OB-RRT) and conduct in-situ drills. The expected outcome is improved response times, self-confidence of OB-RRT team members, communication, and outcomes for obstetrical emergencies.
Methods:
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A literature review was conducted using an assortment of online and digital resources. The literature review revealed a treasure of research and information related to obstetric emergency preparedness and drills. The literature discusses and reviews the effectiveness and purpose in having a rapid response team (RRT). Findings revealed focused patient-oriented outcomes concluding how this process will likely have a major impact on nurses and nursing care at the bedside. All across the United States, RRT’s have become an expected standard of care in the intensive care units and medical floors but it was not until recently American Colleges of Obstetricians and Gynecologists suggested that an obstetric rapid response team be implemented to assist with specific obstetric emergencies. With the increasing numbers of emergencies in labor and delivery, the recommendation was beneficial to not only build self-efficacy and confidence in the nursing staff but have a major impact in healthcare systems and patient outcomes. The cost effectiveness in developing a Code-OB RRT will reduce ICU admission rates and overall maternal morbidity and mortality. The highest percentage of cost for this endeavor was training the team and preparing them. However, the benefits outweighed costs by far.
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Results:
Student Satisfaction and Self-Confidence in Learning questionnaires were completed by eighty-five of the eighty-seven eligible nurses for the team. This was rated on a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree). Out of 55 nurses (78.82%) strongly agreed and 18 (21.18%) agreed they mastered the content of the simulation activity that was presented. This gave a mean of 4.79 and a standard deviation of 0.41. Seventy-one nurses (90.59%) strongly agreed and eight (9.41%) agreed confidence that the simulation covered critical content necessary for the mastery of the obstetrical curriculum. This gave a mean of 4.91 and a standard deviation of 0.29 (see Figure 5). Seventy-five nurses (88.24%) strongly agree and 10 (11.76%) agree on confident they developed skills and obtained the required knowledge from the simulation to perform necessary tasks in a clinical setting. This gave a mean of 4.88 and a standard deviation of 0.32
Conclusion:
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The overall benefit for this quality improvement project was to increase patient safety for both mother and baby. Benefits for the staff include increased knowledge, confidence, communication skills, teamwork, and retention. Providers increased their confidence in staff and team which in turn provided higher satisfaction and engagement. Overall, the hospital showed significant rise in patient safety and a decrease in maternal morbidity. The measurable, positive successes of the concepts listed here are the impetus of long-term sustainability. The one-year plan would include quarterly Code-OB drills as part of the staff’s year core competencies. |