Developing a Systematic Approach to Obstetric Emergencies

To determine the effect of standardized education specific to maternal resuscitation on nurses’ confidence and competence during obstetric emergencies and to determine the cost savings associated with the program. Pre- and postintervention surveys designed to measure perceived confidence and competence in resuscitation before and after Advanced Cardiac Life Support (ACLS) certification in combination with obstetric drills. The project was conducted at a 12-bed labor and delivery, mother/baby unit in an acute care, community-based hospital in Northwest Arkansas. Sixty-seven registered nurses (RNs) who were hospital employees with at least 6 months experience in labor and delivery or the neonatal intensive care unit completed focused education and training. The obstetric ACLS program targeted obstetric emergencies, cardiac arrest in the mother, and simulated drills. Obstetric emergencies included cardiac arrest, postpartum hemorrhage, STAT cesarean, uterine rupture, prolapsed umbilical cord, shoulder dystocia, operative vaginal delivery, and eclampsia. Comparison of pre- and postassessments revealed improvements in perceived confidence and competence when managing obstetric emergencies. Nurse confidence increased by 35% and nurse competence increased by 32%. The 2-day educational program also realized significant cost savings. Overall costs for the educational program decreased from $94849 to $42974. An educationally sound program that included classroom time and focused drills led to increased perceived confidence and competence for nurses and cost savings related to employee education.