Obstetrical history of the patient
Obstetrical history of the patient
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M6A3: Improving Obstetric Patient Outcomes Paper
Maternal morbidity and mortality is a national health problem. Preventing complications of pregnancy is included in
the 2020 National Health Goals. The purpose of this written assignment is to describe how evidenced based
findings can improve patient outcomes related to obstetrical care.
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SAMPLE ANSWER
Obstetrical history of the patient which is associated with the primary problem
The morbidities and mortalities that are attributed to maternal health are without any doubt mind boggling hence it has become a national health problem (Isaacs et al., 2014). This has necessitated the Federal government in conjunction with State governments to develop and implement the necessary maternal healthcare frameworks to help in improving maternal health (Tandu-Umba et al., 2013). As a result, there is inclusion of the strategy for prevention of complications of pregnancy in the 2020 National Health Goals. Patients in labor ward settings are often faced with numerous challenges that are imminent after the onset of labor pains that may be attributed to maternal and fetal age and weight, among others (Isaacs et al., 2014).
The successful completion of gestation period by any pregnant women is usually marked with another challenge involving the delivery of the infant. The only two method of delivery that exist are cesarean as well as vaginal delivery whereby the former is often carried out as a form of emergency to either save the life of the mother or child, while the later involves normal delivery either with mild or no difficulties at all. Thus, high birth weight has to a significant extent been attributed to failed induced labor eventually leading to cesarean section (McGlennan & Sherratt, 2013). Hence, in this paper the risk factor from the obstetrical history of the patient which can be considered to be related with the labor ward incident involving 36 hours of failed induced labor is determined to be the high birth weight of the baby boy, which stood at 9 pound 8 ounce. The infant’s high weight is undoubtedly the straightforward cause of failed induction of labor, which subsequently led to the cesarean section. The determination of this answer is based on the obstetric history where the infant’s weight falls since it began to be monitored may immediately after the conception or some weeks as well as months later.
The rate of induction of labor has been rising over the previous decades whereby a good number of them are initiated for the benefit of both the mother and child. However, induction of labor is also done for convenience and this trend may be the cause of increasing numbers of induced labor across the world (Isaacs et al., 2014). For this reason, obstetrical history of the patient has to be closely and critically considered in order to ensure that any imminent risk factor is timely addressed by conducting the appropriate emergency response or risk mitigation measures. According to Vikram & Sabaratnam (2011), there is need to alleviate the risk factors associated with induction of labor subsequently leading to cesarean section, especially when the birth weight is considerably high as observed in this case while examining Tanya’s obstetrical history because there is no other risk factor associated to obstetric history which can be attributed to failed induction of labor. The high birth weight was without any doubts the cause of the failed induced labor because the infant usually prevents the uterine walls from effectively contracting despite epidural administration of oxytocin subsequently ensuring that Tanya had to undergo cesarean section to save the unborn baby prior to fetal distress (McGlennan & Sherratt, 2013).
Early identification of emergencies in the obstetric setting
Emergencies are often in labor wards, and the need to implement appropriate mechanisms or systems for early detection of these emergencies is undisputedly inevitable. The literature has identified several approaches likely for utilization to achieve positive impacts on patient outcomes including: drills, simulations, protocols, as well as vital sign alerts (McGlennan & Sherratt, 2013). In this paper the vital sign alerts approach is to be discussed.
The benefits of the vital signs alerts approach are definitely extensive but only two which are dominant shall be discussed in this paper. First, vital signs alerts approach has the potential to reduce the number of staff required to attend to the same number of patients as in traditional/conventional healthcare settings because the vital signs alerts approach would notify the doctor or nurse on duty of any emergency without the need to make rounds (Tandu-Umba et al., 2013). Second, the signs alerts approach provides convenience for both the staff and patients because any time the patient needs emergency attention, the alert system will come in hardy in timely notifying the staff concerning any incident which qualifies to call a clinical emergency. This vital signs alerts approach does not come without limitations and the two main limitations include: the need to train all the patients on ho to use the vital signs alerts system upon admissions as well as the possibility of misuse either accidentally or deliberately leading to confusion (McGlennan & Sherratt, 2013).
Ways by which vital signs alerts approach improve patient outcomes in the perinatal setting
When patients in perinatal setting, it means that they ought to be under close monitoring in order to observe any changes. The vital signs alerts approach is undoubtedly the best in improving patient outcomes by ensuring that there is timely response to an emergency which subsequently results to quick recovery of the patients (Tandu-Umba et al., 2013). The other important role of this approach in improving patient outcomes in the perinatal setting is its potential to facilitate life saving, because it helps to raise alarm when a patient is in dire need for emergency medical attention, which often turns out to be the life saving moment (Isaacs et al., 2014).
References
Isaacs et al., (2014). A national survey of obstetric early warning systems in the United Kingdom: Five years on. Anesthesia, 69, 687–692. doi:10.1111/anae.12708.
McGlennan, A. P. & Sherratt, K. (2013). Charting change on the labor ward. Anesthesia, 68, 338–42.
Tandu-Umba, B., Tshibangu, R., & Muela, A. (2013). Maternal and Perinatal Outcomes of Induction of Labor at Term in the University Clinics of Kinshasa, DRC Congo. Open Journal of Obstetrics and Gynecology, 3, 154-157. doi:10.4236/ojog.2013.31A029.
Vikram, T.S. & Sabaratnam, A. (2011). Failed Induction of Labor: Strategies to Improve the Success Rates. Obstetrical & Gynecological Survey, 66, 717-728. doi:10.1097/OGX.0b013e31823e0c69
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