awhonn guidelines

Specialties Ob/Gyn

Published

It came across email today that awhonn is now saying that its safe practice for 5 m/b couplets. I am trying to find that information. Specifically as well what it says regarding pts on mag, antepartums, etc in relation to the 5 couplet recommendation. We are likely going to 5 couplets on an as-needed basis (budget issues being the cited reason). I need to be sure I am performing safe practice. I love my floor and my coworkers but politics are getting weird.

Why does budget have to affect patient ratios? Isn't it more expensive for a pt. to win a free trip to ICU from a complication, rather than have extra nurses on hand? I am sick to my stomach thinking about this change at work...our c-sects need hourly checks X12h, and mag patients are traditionaly just seen as one couplet out of four. Now they will be one out of five!

Anyway, looking for info about awhonn's guidelines. I looked on the site but couldn't find it. thanks.

UPDATE: I received an email in response to my inquiry from an AWHONN rep. She addressed the ratio guidelines this way:

In re the couplet numbers: the guidelines state 1:6 for antepartum and postpartum patients without complications, 1:3 for antepartum and postpartum patient with complications but in stable condition; 1-3-4 for normal mother-newborn couplet care.

So I am thinking, if its 1:6 does it include babies? And I am not sure the difference between AP and PP w/o complications vs normal couplet care.

She also cites a monograph that can be purchased that addresses this issue on the website but I haven't found it yet.

Just an update. Not sure exactly what this will mean....in a meeting last week we were told our 1:5 couplet ratio is temporary until the new budget year in July.

UPDATE: I received an email in response to my inquiry from an AWHONN rep. She addressed the ratio guidelines this way:

In re the couplet numbers: the guidelines state 1:6 for antepartum and postpartum patients without complications, 1:3 for antepartum and postpartum patient with complications but in stable condition; 1-3-4 for normal mother-newborn couplet care.

So I am thinking, if its 1:6 does it include babies? And I am not sure the difference between AP and PP w/o complications vs normal couplet care.

She also cites a monograph that can be purchased that addresses this issue on the website but I haven't found it yet.

Just an update. Not sure exactly what this will mean....in a meeting last week we were told our 1:5 couplet ratio is temporary until the new budget year in July.

No, the 1:6 does not include babies - the difference between AP & PP w/o complications and normal couplet care is the babies. The ratio of 1:6 is 6 AP or PP women for a total of 6 patients per nurse. 1:3 for couplet care is 3 moms + 3 babies = 6 patients total per nurse.

FYI - the new edition of Kathleen Rice Simpson's book mentioned above (AWHONN's Perinatal Nursing) will be coming out in June. If there are changes, they might be there.

1:5 is hard - I've done it. Good luck.

Becki

Specializes in Community, OB, Nursery.

Where I am we usually have 4-5 rooms of pts. Whoever makes the assignments tries to make sure the PP, AP, C/s, & gynies are fairly evenly split. It's usually not too bad. Having 5 couplets is hard. I've done that too & don't like it. Usually we have 3-4 couplets & an antepartum. Sometimes babies are in NICU or something, which gives us less babies. Our load is usually pretty manageable.

Specializes in L&D, M/B.

We have gone to having 5 couplets EVERY night. Budget is the quoted reason. We are also having to pull our RN out of the nursery a few times in the past few weeks (keeping a PCA in there) because we are so busy. The charge nurse takes pts. every night also. We STAY busy!!

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Is the PCA in a nursery with healthy babies? I just wondered...

And I have talked to many who have 5 couplets. I think that is way too much for anyone to get any quality of care---esp if just ONE is unstable, newly c/sectioned/delivered or having breastfeeding problems. WHAT are we coming to??????

ugh tonight was five couplets---I had an FDIU @ 20 weeks w/ fetus in the room, discharge, admit, one relatively normal one but assigned to a student who needed help of course, one w/ insulin dependent gestational diabetes whos baby was released from special care when I got there, and one I picked up that needed a circ and a bath. All couplets but the fdiu and for that I helped the doc obtain a tissue sample. (awfulest thing I ever saw to date)

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

(((((((((((((((((Cooper)))))))))))))))))

Is the PCA in a nursery with healthy babies? I just wondered...

And I have talked to many who have 5 couplets. I think that is way too much for anyone to get any quality of care---esp if just ONE is unstable, newly c/sectioned/delivered or having breastfeeding problems. WHAT are we coming to??????

I don't know about anyone else, but I am coming to the end of my rope, thats for sure. Gem from my tech when I asked her to do a bath and help me out "Oh, I don't feel like it tonight, I have a toothache."

And when I asked her to get fs bg on one pt "Oh, I don't do nothing with blood"

:madface: :madface: :madface: :madface:

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I would write this person up each and every time she says these things and refuses to help. Starting a paper trail will guide her way out the door if she does not stop the shenanigans.

+ Add a Comment