Implementation of an obstetric triage decision aid into a maternity assessment unit and emergency department
The obstetric triage decision aid (OTDA) consists of 10 common pregnancy complaints with key signs and symptoms generating a triage score based on targeted questioning responses. It was developed to provide a standardised approach for obstetric triage conducted by midwives and emergency nurses as ne...
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| Veröffentlicht in: | Women and birth : journal of the Australian College of Midwives 2022-05, Vol.35 (3), p.e275-e285 |
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| container_title | Women and birth : journal of the Australian College of Midwives |
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| creator | McCarthy, Mary F. Pollock, Wendy E. McDonald, Susan J. |
| description | The obstetric triage decision aid (OTDA) consists of 10 common pregnancy complaints with key signs and symptoms generating a triage score based on targeted questioning responses. It was developed to provide a standardised approach for obstetric triage conducted by midwives and emergency nurses as neither professional group are expert in the triage of pregnant and postpartum women.
To evaluate implementation of the OTDA into an emergency department (ED) and maternity assessment unit (MAU).
The OTDA was introduced to the ED and MAU of a hospital in Australia. A range of implementation strategies were utilised and assessed by pre and post staff survey, and a three-month post-audit of unscheduled maternity presentations. The primary outcome was adoption rate of the OTDA. Secondary outcomes were staff confidence and waiting times. Analyses were undertaken using SPSS (v24). Paired analysis was conducted on staff surveys.
There were a total of 2829 unscheduled presentations: ED (n=708) and MAU (n=2121), 88.1% were triaged using the OTDA, used more in the MAU than the ED (93.2% vs 72.7%; p |
| doi_str_mv | 10.1016/j.wombi.2021.06.001 |
| format | Article |
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To evaluate implementation of the OTDA into an emergency department (ED) and maternity assessment unit (MAU).
The OTDA was introduced to the ED and MAU of a hospital in Australia. A range of implementation strategies were utilised and assessed by pre and post staff survey, and a three-month post-audit of unscheduled maternity presentations. The primary outcome was adoption rate of the OTDA. Secondary outcomes were staff confidence and waiting times. Analyses were undertaken using SPSS (v24). Paired analysis was conducted on staff surveys.
There were a total of 2829 unscheduled presentations: ED (n=708) and MAU (n=2121), 88.1% were triaged using the OTDA, used more in the MAU than the ED (93.2% vs 72.7%; p<.001). In the MAU, women seen within 15min of arrival improved significantly from 42.0% to 78.0%. There was improvement in the self-rated confidence (p=.002) and competence (p=.004) by nurses and midwives to conduct obstetric triage.
The introduction of the OTDA required different approaches to change practice. There were improvements in staff self-rated confidence and competence, a reduction in clinical risk associated with under-triage in the ED and improved prioritisation of care in the MAU.</description><identifier>ISSN: 1871-5192</identifier><identifier>EISSN: 1878-1799</identifier><identifier>DOI: 10.1016/j.wombi.2021.06.001</identifier><identifier>PMID: 34183275</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Decision Support Techniques ; Emergency department ; Emergency Service, Hospital ; Female ; Humans ; Implementation ; Maternity services ; Midwifery ; Obstetric triage ; Pregnancy ; Pregnancy complications ; Surveys and Questionnaires ; Triage</subject><ispartof>Women and birth : journal of the Australian College of Midwives, 2022-05, Vol.35 (3), p.e275-e285</ispartof><rights>2021 Australian College of Midwives</rights><rights>Copyright © 2021 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c289t-d29f397ad1fba99d23a5d475a43a874cb2f1727f4de50df6c986d8031fdbf6e3</citedby><cites>FETCH-LOGICAL-c289t-d29f397ad1fba99d23a5d475a43a874cb2f1727f4de50df6c986d8031fdbf6e3</cites><orcidid>0000-0002-1091-3757 ; 0000-0002-6504-6566</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.wombi.2021.06.001$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34183275$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>McCarthy, Mary F.</creatorcontrib><creatorcontrib>Pollock, Wendy E.</creatorcontrib><creatorcontrib>McDonald, Susan J.</creatorcontrib><title>Implementation of an obstetric triage decision aid into a maternity assessment unit and emergency department</title><title>Women and birth : journal of the Australian College of Midwives</title><addtitle>Women Birth</addtitle><description>The obstetric triage decision aid (OTDA) consists of 10 common pregnancy complaints with key signs and symptoms generating a triage score based on targeted questioning responses. It was developed to provide a standardised approach for obstetric triage conducted by midwives and emergency nurses as neither professional group are expert in the triage of pregnant and postpartum women.
To evaluate implementation of the OTDA into an emergency department (ED) and maternity assessment unit (MAU).
The OTDA was introduced to the ED and MAU of a hospital in Australia. A range of implementation strategies were utilised and assessed by pre and post staff survey, and a three-month post-audit of unscheduled maternity presentations. The primary outcome was adoption rate of the OTDA. Secondary outcomes were staff confidence and waiting times. Analyses were undertaken using SPSS (v24). Paired analysis was conducted on staff surveys.
There were a total of 2829 unscheduled presentations: ED (n=708) and MAU (n=2121), 88.1% were triaged using the OTDA, used more in the MAU than the ED (93.2% vs 72.7%; p<.001). In the MAU, women seen within 15min of arrival improved significantly from 42.0% to 78.0%. There was improvement in the self-rated confidence (p=.002) and competence (p=.004) by nurses and midwives to conduct obstetric triage.
The introduction of the OTDA required different approaches to change practice. There were improvements in staff self-rated confidence and competence, a reduction in clinical risk associated with under-triage in the ED and improved prioritisation of care in the MAU.</description><subject>Decision Support Techniques</subject><subject>Emergency department</subject><subject>Emergency Service, Hospital</subject><subject>Female</subject><subject>Humans</subject><subject>Implementation</subject><subject>Maternity services</subject><subject>Midwifery</subject><subject>Obstetric triage</subject><subject>Pregnancy</subject><subject>Pregnancy complications</subject><subject>Surveys and Questionnaires</subject><subject>Triage</subject><issn>1871-5192</issn><issn>1878-1799</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kElPBCEQhYnRuIz-AhPD0Uu3LN1Nc_BgjFti4mXuhIbCMOllBEYz_156Rj16oKhQ770KH0KXlJSU0OZmVX5NQ-dLRhgtSVMSQg_QKW1FW1Ah5eGup0VNJTtBZzGuCKkEZ_IYnfCKtpyJ-hT1L8O6hwHGpJOfRjw5rHPtYoIUvMG56HfAFoyP81x7i_2YJqzxoBOE0act1jFCjHMI3uSHnGBxzgzvMJpt9q51SPP0HB053Ue4-LkXaPn4sLx_Ll7fnl7u714Lw1qZCsuk41JoS12npbSM69pWotYV162oTMccFUy4ykJNrGuMbBvbEk6d7VwDfIGu97HrMH1sICY1-Gig7_UI0yYqVldNQ0g-Wcr3UhOmGAM4tQ5-0GGrKFEzZbVSO8pqpqxIozLl7Lr6WbDpBrB_nl-sWXC7F0D-5aeHoKLxGQZYH8AkZSf_74JvXZWRtQ</recordid><startdate>202205</startdate><enddate>202205</enddate><creator>McCarthy, Mary F.</creator><creator>Pollock, Wendy E.</creator><creator>McDonald, Susan J.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1091-3757</orcidid><orcidid>https://orcid.org/0000-0002-6504-6566</orcidid></search><sort><creationdate>202205</creationdate><title>Implementation of an obstetric triage decision aid into a maternity assessment unit and emergency department</title><author>McCarthy, Mary F. ; Pollock, Wendy E. ; McDonald, Susan J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c289t-d29f397ad1fba99d23a5d475a43a874cb2f1727f4de50df6c986d8031fdbf6e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Decision Support Techniques</topic><topic>Emergency department</topic><topic>Emergency Service, Hospital</topic><topic>Female</topic><topic>Humans</topic><topic>Implementation</topic><topic>Maternity services</topic><topic>Midwifery</topic><topic>Obstetric triage</topic><topic>Pregnancy</topic><topic>Pregnancy complications</topic><topic>Surveys and Questionnaires</topic><topic>Triage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>McCarthy, Mary F.</creatorcontrib><creatorcontrib>Pollock, Wendy E.</creatorcontrib><creatorcontrib>McDonald, Susan J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Women and birth : journal of the Australian College of Midwives</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McCarthy, Mary F.</au><au>Pollock, Wendy E.</au><au>McDonald, Susan J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Implementation of an obstetric triage decision aid into a maternity assessment unit and emergency department</atitle><jtitle>Women and birth : journal of the Australian College of Midwives</jtitle><addtitle>Women Birth</addtitle><date>2022-05</date><risdate>2022</risdate><volume>35</volume><issue>3</issue><spage>e275</spage><epage>e285</epage><pages>e275-e285</pages><issn>1871-5192</issn><eissn>1878-1799</eissn><abstract>The obstetric triage decision aid (OTDA) consists of 10 common pregnancy complaints with key signs and symptoms generating a triage score based on targeted questioning responses. It was developed to provide a standardised approach for obstetric triage conducted by midwives and emergency nurses as neither professional group are expert in the triage of pregnant and postpartum women.
To evaluate implementation of the OTDA into an emergency department (ED) and maternity assessment unit (MAU).
The OTDA was introduced to the ED and MAU of a hospital in Australia. A range of implementation strategies were utilised and assessed by pre and post staff survey, and a three-month post-audit of unscheduled maternity presentations. The primary outcome was adoption rate of the OTDA. Secondary outcomes were staff confidence and waiting times. Analyses were undertaken using SPSS (v24). Paired analysis was conducted on staff surveys.
There were a total of 2829 unscheduled presentations: ED (n=708) and MAU (n=2121), 88.1% were triaged using the OTDA, used more in the MAU than the ED (93.2% vs 72.7%; p<.001). In the MAU, women seen within 15min of arrival improved significantly from 42.0% to 78.0%. There was improvement in the self-rated confidence (p=.002) and competence (p=.004) by nurses and midwives to conduct obstetric triage.
The introduction of the OTDA required different approaches to change practice. There were improvements in staff self-rated confidence and competence, a reduction in clinical risk associated with under-triage in the ED and improved prioritisation of care in the MAU.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>34183275</pmid><doi>10.1016/j.wombi.2021.06.001</doi><orcidid>https://orcid.org/0000-0002-1091-3757</orcidid><orcidid>https://orcid.org/0000-0002-6504-6566</orcidid></addata></record> |
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| ispartof | Women and birth : journal of the Australian College of Midwives, 2022-05, Vol.35 (3), p.e275-e285 |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Decision Support Techniques Emergency department Emergency Service, Hospital Female Humans Implementation Maternity services Midwifery Obstetric triage Pregnancy Pregnancy complications Surveys and Questionnaires Triage |
| title | Implementation of an obstetric triage decision aid into a maternity assessment unit and emergency department |
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