Clinical ladder topics - cervical vaginal exams, communication?

[L&DMomof3]

Hi. I am thinking about starting the clinical ladder process at my current job. I am looking for some ideas that would be good project ideas. Currently, we are contemplating on creating a policy and education process for cervical exams but I am finding that many hospitals do not have actual policies in place....some have guidelines from their educator or check off lists...First, could you tell me if your hospital has a policy or guideline protocol?

Also trying to get some other ideas for other potential projects that are fun but easily measurable....We have many patients that do not speak English...we have interpreters and language lines but most of our paperwork is in English with several copies in Spanish....

Any suggestions or brainstorming ideas is greatly appreciated.

Thank you!

[ashleyisawesome, BSN, RN]

What kind of policy are you looking for? I work in a teaching hospital, so our residents do a lot of the cervical exams themselves. The RNs do them as well when needed, but usually when the residents are tied up with something else and we think the patient might be complete and want to make sure before calling them in from the OR or another delivery. I think it's best when the same person checks the patient consistently if possible, since an SVE can be a little subjective. My 6cm might be someone else's 5cm, or my 70% might be someone else's 80% effaced. Our only policy is patients on pitocin should be checked q2 hours, but it can be deferred if the Dr, patient and RN agree.

No real input on the Spanish thing. We kind of do what you do. Language line and paperwork in English/Spanish. I will say pretty much every consent and educational material has a Spanish version, so our Spanish speaking patients don't miss out. I feel bad for people that speak other languages. We get a lot of Portuguese, Tagalog, Mandarin, Arabic etc and have no materials for them in their language.