Background: Triage concepts have shifted the focus of obstetric care to include obstetric triage units. The purpose of this systematic review is to examine the literature on use of triage concepts in obstetrics during a 15-year time frame.
Methods: A systematic review was completed of the obstetric triage literature from 1998 to 2013 using the electronic online databases from PubMed, CINHAL, Ovid, and Cochrane Library Reviews within the English language. Reference lists of articles were reviewed to identify other pertinent publications. Both peer-reviewed and non–peer-reviewed documents were used. Inclusion criteria: articles specifically related to obstetric triage or obstetric emergency practices in the hospital setting. Exclusion criteria included: manuscripts that focused on general, nonobstetric emergency and triage units, telephone triage, out-of-hospital practices, other clinical conditions, and references outside the time frame of 1998–2013.
Results: Key categories were identified: legal issues and impact of Emergency Medical Treatment and Active Labor Act (EMTALA); liability pitfalls; risk stratification (acuity tools); clinical decision aids; utilization, patient flow, and patient satisfaction; impact on interprofessional education and advanced nursing practice; and management of selected clinical conditions. Components of a best practice model for obstetric triage are introduced.
Conclusion: Seven key triage categories from the literature were identified and best practices were developed for obstetric triage units from this systematic review. Both can be used to guide future practice and research within obstetric triage.
Obstetric triage is a major part of the process of care provided to women who present to the hospital during pregnancy. This systematic review of the literature regarding obstetric triage over the past 15 years offers important information on how obstetric triage has evolved in the United States, best practices, and areas for future research.
Diane Angelini is a Clinical Professor, Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University; Director, Midwifery, Women and Infants Hospital, Providence, RI; Senior and Co- Founding Editor, Journal of Perinatal and Neonatal Nursing, www.jpnnjournal.com. The author can be reached via e-mail at email@example.com
Elisabeth Howard is a Clinical Assistant Professor, Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Women and Infants Hospital, Providence, RI.
The authors declare no conflict of interest.
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