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I've also heard the 50% rate. We're building a new birthing center & are adding another OR room for this. One of the reasons....suppose a woman asked for a C/S because of intuitively feeling something was wrong, but it was denied & there were complications (abruption, ruputre, etc). The woman could have a very strong case in litigation.

Yep. 60 cc into the bladder via foley, then unclamp and drain. Any nicks, the blood will be readily visible. It's sterile--no worries.

Actually, I can't complain about staffing--they are great here. As soon as a patient starts getting active, we go one on one. And, there are generally floats available to assist at del. time or to go to the OR. When I started there, I told them all how "spoiled" they are! Gail

One large, level III nearby uses the "ward" type of triage--4 stretchers per room with a curtain between them. Their logic? Move them through quickly and don't make it too comfortable for the frequent flyers who just want to be admitted and induced for their convenience and/or comfort. There are also no TVs or comfortable chairs for SO. If someone needs to be admitted, they are put into a room ASAP.

Great suggestions----I'm scribbling furiously! Gail

How many poorly-designed units do you see that had NO input from nurses at all as to their set-up????? they can address the above, PLUS security measures intelligently and practically. You won't regret their input. All are great ideas--I've scribbled them down in our "suggestion" notebook--one of the first steps in the process. They're asking for input and ideas...I sure hope they consider them. Last time, they spent tons of money on bathrooms, then, when we got to see them, they had installed "Pediatric" tubs and fixtures--a gestationally mature mom has trouble fitting into a regular adult tub--not to mention a pediatric one! Thanks! Gail

Routine labors get an 18 gauge. Scheduled c/s or other procedures get a 16ga.--sometimes high risk patients get 2 or 3 16 gauges--and absolutely no helplocks if they are getting an epidural--the anesthesiologists have a fit --in case they need to pump in huge volumes of fluid.

Hi all. We are in the early planning stages for a new women's hospital/birthing center. Anyone have any wonderful ideas for things to include or not include? Experience is usually the best advisor....Gail

Because all mixed meds should be done under a "hood" our pharmacy has begun to mix all our meds. Our pitocin for induction is 30 units in 500 cc 0.9% NSS. To give, for example, 1 mu/min, the IV pump is set at 1 ml/hr. 2mu/min is set at 2 ml/hr, etc. For post delivery, we generally run in the rest of the pit bag. If the patient does not have pit going, our post-delivery pit is 20 units pit in 1000 ml. Pharmacy also mixes the mag. We use the Omnicell instead of Pixus, but the premixed meds work well with either system. We still keep some pit vials in the Omnicell, in case we need to give it IM. Gail

Hi all. We (like most others) are using Misoprostal for cervical ripening. Currently our docs and residents administer the med. Our Clinical Practice Committee is considering a protocol that would allow nurses to administer subsequent doses of cytotec after the doc gives the first one. That would allow the doc to first evaluate the cervix and explain the treatment to the patient and answer any questions. At my previous hospital, nurses administered it. What are your experiences with this? Do any of your units allow nursing to administer it--and if so, are there special considerations? The head of our Joint Perinatal Practice Committee says to benchmark it to see what others are doing--Thanks for any input! If you would like to share your facility and its policy concerning cytotec, let me know @ [email protected]. Thanks!

Perhaps if he is capable of getting out of bed, he is capable of changing his bed. In the past, we have put a stack of linens on the stand and said, "If you soil the bed, your new linens are here for when you would like to change them--let us know if you need more." This is only used IF the patient is capable of controlling that particular body function.--Gail