we're expanding our L&D (LDR type) to include a triage/early labor lounge. Looking for info on staffing, policies that may be needed. Have tried researching and come up with ER nursing..Not the same as we all know. We do 2500+ deliveries a year and envision this area to manage all the labor checks and antepartum testing, manned by a nurse(s?) who might also be charge nurse for the L&D? credentials such as OB certification? Do you have or know of a similar unit? Thanks
Mar 24, '00
I work as a doula at Barnes-Jewish in St.Louis MO. I am also an RN trying to get into a L&D dept. We have Triage area I don't know much about it. But maybe you could contact someone there and ask your questions.
Apr 18, '00
I work in a tertiary care center, which does ~7000 deliveries/year, so I do not know how comparable it would be to meet your needs. But our OB Triage has 8 beds, with curtains separating the beds. (We are currently outgrowing our OB triage-with patients ending up waiting in the waiting area until a triage bed becomes available.) Patients come to triage first-OB registration is right outside the door. We usually staff with 2 nurses-sometimes need another. With our census, this can get hairy at times, because if you end up putting someone on the monitor to find you need to crash section this patient directly from triage-it is often that triage nurse who goes back to circulate-possibly leaving one nurse with 7+ patients. But it is nice to not tie up LDR beds for R/O SROM, R/O labor, and NSTs, patients coming in for gels who go home after an hour, etc.
Apr 18, '00
OB4ME, thanks for the info..do you have protocol to follow regarding who gets in triage area and when/ how discharged or transfered. (Right now we have just an exam room..it's drag to admit for a stat C/S from there too)
[This message has been edited by Cindy Palmer, RNC (edited April 18, 2000).]
Apr 21, '00
Unless the MD specifically orders for a patient to be directly admitted to the floor-every OB patient (I believe >17 weeks?) comes to our triage. RNs fill out the first page of our OB admission assessment (which covers the basic nsg H&P, incl domestic violence screen, as well as presenting complaint and SVE,etc.) on every patient who walks through the door. Then, they are all placed on the monitor for an NST. The RN will perform necessary testing (SVE, spec exam, fern&nitrazine testing, etc) If the patient is r/o labor, we can walk her for 1-2 hours after obtaining a reactive NST before calling the MD-otherwise the doctor would be called around this point. Then, orders would be obtained for admission, continue to monitor, or d/c home. We also have the benefit of in-house residents who we call for anything questionable. It works pretty smoothly-most of the time.
Apr 21, '00
OB4me, thanks! that helps a lot!-we've just started training the newer nurses on vag exams--got out of the habit when we started our resident teaching program- cindyP
Jun 27, '00
We triage all OB patients that come into or unit. Unless we feel delivery is immediately. We have a special room for triage and usually do our NST there also. An LPN may triage with an RN over seing her.
Jun 30, '00
It was quite interesting to read how other facilities manage triage!! Our unit doesn't have a specific room for triage; we have 3 observation rooms, which are rather small and can be used for NST's, etc. But a lot of times we end up with our LDRP rooms tied up with early labor, ?SROM, etc...which can get really hairy on our busy nights!! Our unit is set up so that an RN has to evaluate the pt within 30 minutes and the physician must be notified within an hour. It'd be nice to have residents in-house (I think; you hear horror stories about residents
ha ha). Construction is beginning for a new LDRP "center"; it's supposed to have a traige area, but who will staff it remains to be seen (we're already short staffed)!
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