The Art of Communication
Name one information exchange strategy
•Situation—Background— Assessment—Recommendation (SBAR)
•CHAT
•Handover
Frequency of IA in the latent phase if admitted to L&D
At least Q1 hour
WITH contractions
Periodic
Onset, nadir and recovery mirror the onset, peak and end of the contraction
Early deceleration
An intervention used to relieve intermittent umbilical cord compression by restoring the amniotic fluid volume
Amnioinfusion
The transfer of information during transitions in care across the continuum
Handover
Frequency of IA during active second stage (when pushing)
At LEAST Q 5 minutes or immediately following each contraction
NOT with contractions
Episodic
Onset, nadir and recovery occur AFTER the onset, peak and end of contraction
Late Deceleration
The practice of having EFM tracings viewed at regular intervals by more than one person
Fresh Eyes
Name two communication challenges when working in teams
•Interruptions
•Task absorption
•Verbal Abuse
•Fatigue
•Not following plan of care
•Ambiguous orders or directions
•Change in team members
•Workload
Timing of FHR auscultation in relation to the contraction.
Immediately following the contraction
Greater than or equal to 3 in a row
Repetitive
Has an abrupt onset, is greater than 15 seconds in duration and falls greater than 15 beats below baseline
Variable deceleration
Improve maternal status, improve uterine blood flow, Improve umbilical circulation, Improve placental perfusion.
Goals of intrauterine resuscitation
Name two factors that contribute to effective communication.
•Mutual respect
•Language that is clear and precise
•Timely flow and transfer of relevant information
•Clear delineation of the roles of the communicators
•Respect for confidentiality
•Conducive environment
Inclusion of everyone the information affects
After a baseline has been established The FHR should be auscultated for this long
30-60 seconds
Occurring with greater than or equal to 50% of contractions in 20 min.
Recurrent
A variable deceleration lasting ≥60 sec. AND down to ≤60 bpm or decrease by ≥60bpm below baseline
Complicated Variable
Provides an indirect assessment of acid-base status
Fetal scalp stimulation
Name two reason that Teamwork is important in the clinical setting
•Reduced clinical errors
•Improve patient outcomes
•Improve process outcomes
•Increase patient satisfaction
•Increase family satisfaction
•Increase staff satisfaction
•Reduce staff turnover
•Reduce patient and family grievances and complaints
Two features of the FHR that cannot be identified by auscultation
Variability and type of decel
Occurring with less than 50% of contractions in 20 minutes
Intermittent
Classification of late decelerations if intermittent (<50% in 20 min.)
Atypical
Presence of THIS is a crude indicator of fetal oxygenation as it reflects an intact CNS
Variability