Postpartum admission criteria

Tweety, BSN, RN · Nov 6, 2007

Welcome to Allnurses.

Moving to OB nurses forum since you have a specific question.

RNLaborNurse4U · Nov 7, 2007

Our postpartum unit only takes STABLE postpartum patients. No one on magnesium or needing mag therapy initiated (those patients always go to us on L&D). Postpartum can hang blood products however, but the patient must have stable lochia/bleeding before transfer to postpartum.

Any slight inkling of being unstable, they are admitted or remain on L&D.

nurseynightnight · Nov 8, 2007

My answer may be a little different than others since I work in a smaller hospital.

Our nurses do antepartum/labor/delivery,postpartum and nursery. We are all one unit.

But having said that we do have some restrictions. We do not take anyone under 20 weeks (ectopics, miscarriages) except for the occassional early fetal demise.

And once a patient goes home...even if only for 2 hours then must be readmitted they go to the medical floor. This includes babies that are sent home.

bagladyrn, RN · Nov 9, 2007

I have worked units where patients were admitted up to 6 weeks postpartum, though more often in the first postpartum week if they developed PIH or a c/s incision infection. I've also seen units where anyone at any stage of pregnancy who had a problem which coukld be attributed to pregnancy (gestational diabetes, hyperemesis, etc.) was admitted to the postpartum unit (usually in hospitals with combined L&D/PP units) regardless of gestation.

NurseNora, BSN, RN · Nov 11, 2007

Once a woman has been sent home, she is readmitted to Med Surg, not OB. We occasionally take some GYN patients if M/S is full, so it wouldn't be unheard of for us to take an ectopic pregnancy, but it doesn't happen often. If someone is still severely hypertnesive 2 weeks after delivery, my opinion is that she needs to be seen by a cardiologist, not an obstetrition.

crysobrn · Nov 11, 2007

We are a smaller hospital... so all l&d, postpartum, antepartum etc is all together. We do not readmit infected cases. We will readmit for high bp's if needed or maybe for hemorrhage (I haven't seen one in a long time). But other than that we see patients over 20 wks with an occasional exception... for example if we have NO patients and there is a hyperem pt or some OB related pt we will take them.

mitchsmom · Nov 17, 2007

If someone is still severely hypertnesive 2 weeks after delivery, my opinion is that she needs to be seen by a cardiologist, not an obstetrition.

Preeclampsia can happen postpartum up to 6 weeks according to the Preeclampsia Foundation: http://www.preeclampsia.org/FAQ.asp#nine

I love their website by the way! Everyone should check it out!

richelle362 · Dec 24, 2007

My hospital is large. On postpartum we take only healthy moms and newborns. There is a floor that takes antepartums, and high risk postpartums, like those on mag, or methadone. They have a remainder nursery for babies that will be staying after mom's discharge. If a patient is readmitted, she goes to med surg.

klone, MSN, RN · Dec 24, 2007

We have no official policy WRT PP patients - it's up to the charge nurse, the staffing, the census, etc. We often do "special favors" for nurses or female doctors who have non-OB medical problems or surgeries and would prefer to be cared for on our floor instead of med-surg. When staffing and census allow, we always try to accommodate. The OBs believe that a postpartum mag patient is going to received better, more knowledgeable care in our department, where the nurses are familiar with using mag for blood pressure issues, as opposed to the med-surg floor, where a nurse would PANIC if she saw a mag level of 7.8.