Need input on pit protocol

I work at two hospitals and one does them q 30 minutes and one q 2 hours

I don't understand how they can be so different across facilities.

Thanks for the responses. No, really, I do mean q15min maternal vitals. That's why I'm trying to change the protocol, because I don't find any science to back it up. I think hourly vitals until the epidural are adequate. Any more ideas let me know.

Lisa

I've tried to find this on the AWHONN site and can't. Can you tell me how to do this? I've also got our chairman of OB to look in his references, and he says he knows of no rationale for the protocol either.

Lisa

ACOG technical bulletin on induction with oxytocin says vitals should be evaluated whenever there is an increase in pitocin. That would still be q20-30 minutes. Is assessment the same as documentation? Lippincott says that initialing the strip is good enough, but what if the strip is lost? I'm about ready to split the difference and say document to vitals on the labor progress sheet q30min. What do you think?

If that is ACOG's recomendation, then I would go with that.

Like I said, we do them q 30 minutes at my 500 bed medical center, and we follow all ACOG guidelines to the TEE.

The small hospital that does them q2 hours also doesn't adequately prepare for emergencies, and has us increase the pit by 2mu every 15 minutes! I believe ACOG says under no uncertain terms that it should be increased by 1-2mu q 30.

q 15 min vitals is a hold over when the pt was upped every 15 min.

Today the recmendations are every time you up the pit, you do PRBp - Pitocin can cause pulmonary edema.

if the pit is at a steady rate q1 hour

ours are BP & HR q30" *and* anytime pitocin doses are increased (some MDs increase q15")

Temp protocol tied in with intact vs ROM....routine is q4...SROM is q2...febrile is q1 & as needed

Yep. Thats it.

q 30 or when pit is upped. We also do q 4 if no rom and q 1hr if rom.

Jared