Jemma

What kind of sleeping pill is being ordered for your moms after delivery? We have used Dalmane 30mg prn for years- pharmacy is suggesting to switch to Ambien.

In this case the intended parents are the genetic mother and genetic father.

We have a surrogate mother giving birth to twins due next month- the parents of the baby will be present to care for the babies, sign consents, etc. What are others policy on the ID bands on the babies? Do we band them with the birth mother or band the babies and the intended parents? We haven't had this situation before and are struggling.

Looking for others policy on documentation of FHR during second stage of labor (with urge to bear down) if on continuous fetal monitoring- one source states "FHR must be evaluated every 5 min" Do others document a FHR every 5 min on the record? If not every 5 min, how often?

JCAHO standard says all medications poured into another container on a sterile field must be labeled-- how are others addressing this with local on Delivery Room tables? On our department local is only poured to a sterile med cup on the table for the provider if needed and immediately before they draw it up in their syringe. There are no other meds placed on the DR table. Would like to know what others are doing?

We are getting ready for JCAHO survey and another nearby hospital said the surveyors were requiring documentation specific to recovery after epidural. I don't understand why- if has been discontinued,is it any different from routine recovery after delivery?- did you find anything in your research? Thanks

Has anyone been through a recent JACHO survey. Wondering what their focus is for OB units? Anything anyone could share about their survey would be appreciated. Thanks

What are others doing?- What is your concentration? What is your starting dose? How often is it increased? What is your maximum dose? Does anyone use a premixed bag? If so, what is the concentration?

We went through a mock survey with the new tracer method- it's going to be quite different from the past. Please let me know how your survey goes. One thing that came up was having the pharmacy mix the Pitocin for inductions/augmentations. Does your nursing staff mix it or the pharmacy? Is your pharmacy open 24 hours?

We recently had a consultant visit to help us prepare for a future JCAHO visit. One important focus is Medication Management- she said it was necessary to mark (on the label ) every time a change is made in the dose (titration) of an IV medication - such as Pitocin- we usually titrate every 30 minutes - I asked her if the info was documented on the bedside chart if this was OK and she said it still needed changed on the bag. Are others doing this? Has anybody gone through the JCAHO survey and have this be an issue? Also are others mixing Pitocin infusions (for inductions) in L & D or having pharmacy do this?

How are others caring for post-op patients with epidurals? Nurse to patient ratio? Are patients on any electronic monitoring? Are these patient on the general surgical floors? Before removal of epidural, are others getting Duramorph? Any complications?

Just wondering what protocols are used in determining which patients are drug tested in your labor rooms. Do you inform the patient that the test is going to be done? What is the usual followup with the newborns if the mom has a positive drug screen?

here's our rule: (50 deliveries per month give or take) bottom line rule is that we must have 2 nurses in the department at all times trained in l&d. if there are 4 on days and we flex down to 3, that nurse can be 40 min away, if there are 3 on off shifts and we flex down to 2, that third nurse must be within 20 min of the hospital or take her call time in house sleeping in spare room. occasionally we staff the pp area with a orientee, float, or nursing instructor not trained in l&d, in this case she is always on call first if she is on with only 2 other nurses. we recently closed our unit, we take turns taking 24 hours of voluntary unpaid call every month where we will come in extra when all heck breaks loose, in exchange for not be pulled to med surg, we don't have floats on pp anymore either. this vol. on call time for times of increased need has an obligation to be here in 40 min. as the dept already has base staffing. valene ([email protected]) i am using my friend's computer (another member)