It’s been a short three months since PeriCALM® went live at Ochsner Baptist, but Melanie Williams, Director of Labor & Delivery is already seeing a positive impact.
Like many obstetric units, Ochsner Baptist is seeing many of their more experienced clinicians retire and bringing on board less experienced nurses. PeriCALM Patterns provides her team with a “safety net” for tracing assessment that, in conjunction with mentoring, reinforces their EFM skills in real-time, at a glance.
About Ochsner Baptist
Located in New Orleans, LA, Ochsner Baptist is home to a state-of-the-art Women’s Pavilion that makes it easier for women of all ages to connect to the expert they need. The site offers both standard and specialized obstetric and gynecological care that includes robotic surgery and high-risk maternal-fetal specialists. The labor & delivery unit includes private perinatal and postpartum rooms, alternative birthing options such as water births and spa services.
About PeriCALM® Patterns™
Using NICHD guidelines, PeriGen’s patented pattern-recognition tool helps clinicians distinguish important labor trends. While providing simultaneous, real-time viewing of FHR and contraction details, it also includes a four-hour view of the strip for trend analysis and visual cues that enable intuitive assessment of labor. In addition, Patterns calculates and presents FHR patterns and contraction measures such as Montevideo units.
This is a story about how labor & delivery nurses from across the United States fixed a problem. And it’s not a fairy tale. It all started at last year’s AWHONN National Convention when PeriGen asked those who stopped by the booth one simple question:
What’s your biggest EFM challenge?
The overwhelming answer: Double documentation. The waste. The toggling between EFM and EHR. The resulting headaches, the inaccuracies, and the overtime.
We came back from the convention and got to work. This year, again at the AWHONN National Convention at Booth 615, we’ll showcase our answer. A way to cut double charting and way to help OB nurses spend more time on what matters most to them.
We’re even giving those who visit Booth 615 a chance to take home the gift of time, right away in the form of PeriGen’s “Gift of Time” watches. Stop by and see the answer to your double charting challenges — and feel free to give us the next challenge on your list.
National Nurses Week goes through May 12th. PeriGen’s Labor Nurse Appreciation Kit makes it easy to say thank you with an email template, suggestions for “thank you” gifts that labor nurses love and a quick link to the American Nurses Association Resource Toolkit as well.
The best comment so far about the National Nurses Week Labor Nurse Appreciation Kit
“The Labor Nurse Appreciation Postcard and baby bottle sugar cookies arrive tomorrow to thank all the OB nurses at the hospital around the corner. What I wouldn’t give to see how the team likes them!”
PeriGen has put together an entire toolkit to help managers and parents show how much their labor nurses are appreciated in honor of this year’s National Nurses Week.
To celebrate National Nurses Week, PeriGen has just posted their National Nurses Week Appreciation Toolkit created especially for OB Nurses
The kit includes a simple-to-print “thank you” postcard to send to your favorite labor nurse(s), an email template, and links to appreciation gifts perfect for labor nurses – cookies shaped like scrubs and baby bottles, a foot spa basket, a link to GrubHub for ordering lunch. (A recent PeriGen poll found that labor nurses often don’t take time out for lunch.)
There’s even a link for expectant mothers to “10 Things Your Labor Nurse Wishes You Knew” by Shelly Lopez-Gray, a labor nurse and pregnancy blogger (Adventures of a Labor Nurse).
Amy Dagestad, Director of Labor & Delivery at Mary Greeley Medical Center in Ames, Iowa had the following words to say when we asked her what they like about their PeriCALM decision support system:
“Although we don’t use all of the PeriCALM integration features, those we do use make life easier. The interface is intuitive and the system is easy to use. We value the availability of PeriCALM Patterns too, especially for difficult labor cases. The users like the system and that’s very important.”
Birthways at Mary Greeley Medical Center serves central Iowa, welcoming more than 1,000 newborns into the world each year. The center is a convenient, comfortable, soothing place for childbirth. It’s designated as a Baby-Friendly hospital by Baby-Friendly USA for its quality of care.
Birthway offers patients 22 private rooms, 13 of them equipped as labor/delivery/recovery/postpartum where mothers and their new babies stay from registration until release. The hospital also offers a host of amenities to make families comfortable including room service and whirlpool tubs.
“We love PeriCALM because it makes it easier. Easier on the eyes. Easier to find information. Easier to get the details we need to do our work.”
We were lucky enough to catch Megan Mcfall this week during a rare moment of calm. Megan is the Director of Women’s Health Care at Indian River Medical Center serving Vero Beach, Florida. Megan leads a busy team of labor & delivery nurses that she describes as “small, but extremely dedicated and skilled.” In fact, each of her team share competencies across all three areas of their women’s services, providing a continuity of care that’s both logical and rare.
We took the opportunity to ask Megan what she liked about PeriCALM. Her prompt answer: “It’s easy.”
Things labor & delivery nurses eat (besides a sandwich) while waiting for the next alert
From our “What would you do with 40 free minutes poll” (see below) most labor & deliver nurses would love to just leave on time to spend time putting their feet up, spending time with family and fun. But a good many say they’d actually spend the time enjoying lunch. So here’s a quick list of ideas for lunch-on-the-run, literally:
- Calzones, warmed in the lunchroom or at home, then wrapped in foil
- Leftover pizza
- Bento box of veggies for grab-and-runs
- Thermos meals — non-chunky soups, dumplings
- A slice of yummy quiche
Every year, according to a study published by The New England Journal of Medicine in 2011, just over 11% of obstetricians and the hospitals and clinicians serving them, will be faced with malpractice complaints. The average payout will be approximately $360,000 with significant state-by-state variation.¹
PeriGen’s Annual Review of
Labor & Delivery Malpractice Awards
Following is a summary of 2015 perinatal malpractice awards, settlements and complaints:
- $8.4 Million Awarded for Hypoxic Ischemic Brain Injury: Mother was admitted to the a Georgia medical center for delivery of a full-term baby. The labor continued throughout the evening. Baby was delivered around noon the next day. Her admitting physician was not present at the delivery, but delivery was overseen by a CNM. For several hours prior to the delivery, fetal heart rate was noted as decelerating and variable. Infant was born severely depressed, with low APGAR scores and metabolic acidosis. He was not intubated for 8 minutes, and he continued to deteriorate, a full code ensued, and resuscitation occurred. Ultimately, infant was diagnosed with a hypoxic ischemic brain injury and developed cerebral palsy. Click for details
- A Michigan court granted the right to appeal for a case stemming from a 2008 delivery outcome. Mother was admitted to the hospital with ruptured membranes. She had a lengthy labor – 29 hours – augmented by the drug Pitocin. The baby failed to descend after two hours of pushing. The mother had developed chorioamnionitis (placental infection) and the doctors noticed the presence of meconium. The labor was terminated with a caesarian section. Records revealed “delivery of a healthy baby boy who weighed 9 lbs 13 oz. However, the infant began to show signs of seizing shortly after his birth and a CT scan revealed an acute left middle cerebral artery ischemic stroke, which was “days to hours old.” The complaint alleged that “[t]he baby was at risk for, and did develop, brain injury from traumatic head compression and regional cerebral ischemia caused by failure to descend, macrosomia (large baby), excessive contractions in the presence of failure of descent as augmented with oxytocin, hypoxia-ischmeia (regional cerebral and/or systemic) caused by uteroplacental insufficiency and by cord compression and head compression.” The complaint alleged that defendants were negligent in administering oxytocin, in failing to properly respond to fetal heart rate changes, and in failing to perform a timely c-section. Click for details
- A couple in Puerto Rico filed a suit for $27 million against two hospitals as a result of respiratory failure, perinatal asphyxia, and clinical sepsis. After experiencing pelvic pressure and secretions the mother was admitted without contractions or amniotic rupture. The mother underwent induced labor. Upon birth, the newborn was found to be in critical condition. His skin was blue from poor circulation, and he did not respond to any external stimuli. The boy was rushed to NICU and hooked up to a mechanical ventilator. He was diagnosed with respiratory failure, perinatal asphyxia, and clinical sepsis. After nearly a month of care, the boy was released from treatment. Then in January 2013 doctors diagnosed him with multicystic leukoencephalopathy and microcephaly, from which stemmed a host of motor, mental, and sensory complications, such as seizures and impaired vision and hearing. Click to review case
- A New Jersey family realized a $700,000 malpractice settlement as a result of a Erbs palsy brachial plexus injury. The case contends that the attending physician used excessive traction during delivery, resulting in stretching and tearing of the brachial plexus. See details
- Another settlement, this one for $562,500 followed a complaint that the obstetrician and nurse, monitoring a patient in labor, failed to recognize that the infant’s heart rate had slowed when the fetal monitor strips was actually demonstrating the mother’s heart rate. The mother’s uterus had abrupted, causing a lack of blood flow and oxygen to the baby. By the time the error was recognized, the infant had died from lack of oxygen. Details provided here
Hypoxic ischemic encephalopathy (HIE) with extensive brain injury is the subject of a recent medical malpractice claim brought against a military hospital in the District of Columbia. The complaint states that after being admitted to the medical center in the early stages of labor, the plaintiff was given oxytocin to help augment contractions. Subsequent fetal heart monitoring suggested an abnormally high rate of contractions, but augmentation was continued. Following this, medical records indicated an increase in the fetal heart baseline along with intermittent late decelerations. Shortly thereafter, the mother developed a fever and was diagnosed with chorioamnionitis (a bacterial infection of the fetal membranes). After several hours of prolonged labor, the plaintiff was delivered, at which point shoulder dystocia was noted. Allegedly, a first year resident then unsuccessfully attempted to relieve the shoulder dystocia with downward pressure. Next, a third-year resident tried several maneuvers to free the baby’s shoulder, including the McRoberts maneuver, the Rubin maneuver and others. All were ineffective. At this point, contends the complaint, the attending obstetrician arrived and was able to successfully free the shoulder allowing for a vaginal delivery. Upon delivery, the plaintiff’s little girl was was described as having bruising on the face and scalp, a fractured right clavicle and Erb’s palsy. She was also hypotonic and experienced seizures. About five days after her birth an MRI revealed that the child showed hypoxic ischemic encephalopathy with extensive brain trauma. See more
Honolulu based hospital faced with $9,000,000 obstetric settlement: The mother arrived at the hospital at 35 weeks into her pregnancy, she had severe lower abdominal pain. Because of her previous history of miscarriage and the complicated delivery of her first child, the mother had undergone a procedure to keep her uterus closed until delivery and the pregnancy was under close supervision. However, when she arrived at the hospital, the hospital failed to notify and consult her obstetrician. An emergency C-section was performed, but the complaint contends that the procedure was not performed in time to prevent reduced oxygen flow to the fetal brain, causing brain damage. Click for more information
- A $5 million suite filed against a military hospital in Kentucky also results from HIE. The suit contends that connected to a fetal heart rate monitor, the healthcare workers failed to properly monitor and interpret the tracings. The plaintiff claims that the medical records indicate her daughter was in respiratory failure for a long period of time. In addition, the complaint states that, despite knowing that the labor was not progressing properly, healthcare providers failed to perform a cesarean section. The newborn was diagnosed with intracerebral hemorrhage and interventricular hemorrhage. Click for details
¹Anupam B. Jena, M.D., Ph.D., Seth Seabury, Ph.D., Darius Lakdawalla, Ph.D., and Amitabh Chandra, Ph.D. Malpractice Risk According to Physician Specialty N Engl J Med 2011; 365:629-636