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
Q1 hour
with contractions
periodic
onset,nadir and recovery mirror the contraction
early decel
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 in the second stage
Q 5 minutes
not with contractions
episodic
onset, nadir and recovery occur after onset, peak and end of contraction
Late Decel
The practice of having EFM tracings viewed at regular intervals by more than one person and has been used widely across the United Kingdom
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
during what part of the contraction should the FHR be Auscultated
after the contraction
greater then 3 in a row
repetitive
has an abrupt onset, is greater than 15 seconds and greater than 15 beats below baseline
Variable decel
Improves maternal status, improve uterine blood flow, Improves umbilical circulation, Improve placental perfusion.
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 how long should the FHR be auscultated
30-60 seconds
occurring with greater than or equal too 50% of contractions
recurrent
Lasting ≥60 sec. AND down to ≤60bpm 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
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