1. Decreased rates of shoulder dystocia and brachial plexus injury via an evidence‐based practice bundle
- Author
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Sienas, Laura E, Hedriana, Herman L, Wiesner, Suzanne, Pelletreau, Barbara, Wilson, Machelle D, and Shields, Laurence E
- Subjects
Reproductive Medicine ,Biomedical and Clinical Sciences ,Clinical Research ,Pediatric Research Initiative ,Adult ,Birth Injuries ,Brachial Plexus ,Cesarean Section ,Dystocia ,Evidence-Based Practice ,Female ,Humans ,Infant ,Newborn ,Patient Safety ,Pregnancy ,Prospective Studies ,Risk Factors ,Shoulder ,United States ,Brachial plexus injury ,Patient safety ,Shoulder dystocia ,Paediatrics and Reproductive Medicine ,Obstetrics & Reproductive Medicine ,Reproductive medicine - Abstract
ObjectiveTo evaluate whether a standardized approach to identify pregnant women at risk for shoulder dystocia (SD) is associated with reduced incidence of SD and brachial plexus injury (BPI).MethodsBetween 2011 and 2015, prospective data were collected from 29 community-based hospitals in the USA during implementation of an evidence-based practice bundle, including an admission risk assessment, required "timeout" before operative vaginal delivery (OVD), and low-fidelity SD drills. All women with singleton vertex pregnancies admitted for vaginal delivery were included. Rates of SD, BPI, OVD, and cesarean delivery were compared between a baseline period (January 2011-September 2013) and an intervention period (October 2013-June 2015), during which there was a system-wide average bundle compliance of 90%.ResultsThere was a significant reduction in the incidence of SD (17.6%; P=0.028), BPI (28.6%; P=0.018), and OVD (18.0%; P
- Published
- 2017