transferring vaginal deliveries to postpartum/gyn unit

[StrongRN]

:angryfire I have a gyn/post partum unit with 29 beds. Our hospital has just recently gone to the LDR approach for new mothers. My question to you is: At what stage of her recovery does this new mother get transferred to your unit? Do you have policy and procedures in place r/t mom being able to empty her bladder either on her own or by catherization? Does she have to be able to move her lower extremities to get score on aldrete scale? Does your unit handle just postpartums or do you have both postpartum and gyn, as well as antepartum patients? I really need to know the "norm" out there now.

PLEASE GIVE ME YOUR INPUT FROM YOUR FACILITY. I AM TRYING TO BRING OUR STANARDS OF CARE UP TO GRADE

[fourbirds4me]

I believe we can transfer with an aldrette of 8 (might be 7 not sure). Personally I like my vag deliveries to be up walking and voiding. This usually occurs within 1.5 hours or so.

[Sable's mom]

I have worked the last 5 years in small hospitals - 1 had LDRPs so transferring was unnecessary. My current unit has LDR rooms, then we transfer to PP - BUT - the same nurse staffs L&D as PP, we only move the patients so we can use the LDRs for incoming moms.

All this said - I can't imagine transferring a mom until she is recovered - to me that means walking and voiding!!

:)

[fiestynurse]

It all depends on how busy it is in L&D. Sometimes it's a matter of needing a bed for a laboring mom that just walked in the door.

It is nice to have the lady partsl deliveries fully recovered when transferred (this means walking and voiding) However, sometimes certain patients need to be triaged out to avoid someone having to deliver in the hallway!

I have worked in all areas of Maternal/Child Health and have recovered many fresh lady partsl deliveries on the post partum floor.

I have also taken care of antepartum patients on a gyn/postpartum unit. It's important to be crossed trained in all areas and work as a team.

[SmilingBluEyes]

does not apply to me since we are an LDRP, we do it all.

but when i worked L/D and PP, we did not transfer anyone who could not walk and void on her own. Yes at times it caused problems and if were THAT HARD UP FOR A ROOM, we made rare exceptions, but they were very busy in PP as well, so we had to be careful to transfer STABLE patients to ensure they would be ok there.

[L&D_RN_OH]

We have LDRP's and PP. We can only keep a certain amount back in our LDRP's before we have to transfer up front. We transfer with a score of 8 or above. We always get them up to the bathroom for peri care before moving so they obviously have to be able to walk, but that's within an hour and a half of delivery usually. If they voided or were cathed just prior to delivery, they may not feel the urge to void yet. So they aren't required to void before transfer. If they void, we DC the IV if they have one. If not, it is left in, until the first void. The protocol states if unable to void within 6 hours PP, a straight cath is done. If another cath is required, a foley is put in.

[Fgr8Out]

L&D keeps patients beyond 3-4 hours?

Our facility is so hopping, we often receive a post partum mom little more than an hour following delivery. There aren't enough L&D beds to keep a post partum mom there until she's been able to void or regain total sensation following anesthesia.

L&D = labor and delivery. Post partum = following delivery.

Newborns are in transition for a couple hours in nursery, so we're able to have some time to care primarily for Mom. And there are many reasons voiding might not take place for some time after delivery. I've never heard post partum complain, other than at the sheer volume of patients we might receive... and like we have control over that :roll

[webbiedebbie]

I work a PP/GYN/antepartum unit. We have received moms who had not voided in L&D, but are able to walk to the bathroom and try. If bladder is not distended, she can be transferred as long as she is able to ambulate.