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IOL < 39 weeks initiative

IOL < 39 weeks initiative. May 2012 Patricia McAfee, RN, MSN. Why the need for initiative?. Although we are not talking about infants this small. Infants close to term can be placed at risk. H&HN Faily.

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IOL < 39 weeks initiative

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  1. IOL < 39 weeks initiative May 2012 Patricia McAfee, RN, MSN

  2. Why the need for initiative?

  3. Although we are not talking about infants this small

  4. Infants close to term can be placed at risk

  5. H&HN Faily Estimated up to 10% of all U.S. deliveries are induced before 39 weeksApril 26, 2012

  6. Recognized as an issue of growing concern • ACOG working on initiative since 1979 • National Quality Forum; 2008 • Joint Commission; 2009 • Institute of Healthcare Improvement; 2010 • March of Dimes supporting with toolkit • California Maternal Quality Care Collaborative • “Quality Care for Moms & Babies Act” of 2011 (H.R. 3620)

  7. Our plan

  8. Investigate the issue • Investigated the issue: • identified we could do better. • Informed physicians at OB-section meeting we were going to monitor IOL <39 weeks for medical indications.

  9. Developed & empowered • Developed a tool to use at time of scheduling • Empowered nurses to ask for indications.

  10. Designed & monitored • Designed variance report for data collection. • Monitored several months to trend behavior.

  11. Reporting findings • Began reporting findings at OB-section meetings. • Section Chairman, Ramani, Physician Champion

  12. Our results

  13. Performance Indicators

  14. July 2011-March 2012

  15. Improvement achieved • IOL < 39 weeks reduced from 6-8/ month to 2-4/month; with many months at one • Documentation of approved medical indication improved from 40-50% to 100% • DRAMATIC improvement seen in December; from 15 in 2010 to 4 in 2011 with 100% meeting approved criteria

  16. Collaboration between physicians & nurses results in improved safety

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