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Improving the Safety of Labor & Delivery With the Use of Telemedicine

A Nursing Perspective on eL&D [9A]

Conway, Stephanie M., MD; Jones, Stuart, MD; Book, Nicole, MD; Elliot, John, PhD, MPH

Obstetrics & Gynecology: May 2016 - Volume 127 - Issue - p 14S
doi: 10.1097/01.AOG.0000483304.66272.3b
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INTRODUCTION: In an effort to improve patient safety at our institution, we instituted an electronic Labor and Delivery (eL&D) program for remote electronic fetal monitoring. The aim of this study was to examine nursing attitudes toward eL&D before and after implementation.

METHODS: After receiving IRB exemption, labor and delivery nurses completed surveys before and 1 year after initiation of the eL&D. Participation was optional. Surveys were anonymous and included demographic information, personal perceptions of eL&D clinical outcomes and perceptions of changes in workflow.

RESULTS: Response rates were 61.7% for initial surveys and 61.2% for final surveys. Questions regarding safety demonstrated a decrease in agreement of eL&D usefulness from initial to follow up surveys. A decrease in the perception that eL&D would improve the number of “good catches” regarding fetal heart tracings; 62.0% (95% CI: 48.1–75.9) versus 32.7% (95% CI: 19.0–46.3) was demonstrated. Questions regarding workflow demonstrated concerns regarding interference with bedside nursing No increase in work load was perceived between the two surveys. Open ended comments expressed concern about eL&D taking away floor staff, eL&D being used as a chart auditing system, and the belief that eL&D would cause interruptions during emergency situations. Overall, 26.5% of respondents felt that eL&D should continue.

CONCLUSION: Labor and Delivery nursing staff perceptions suggest limited nursing support of eL&D. These findings should be considered in determining future dissemination plans.

Riverside Methodist Hosp-Ohio Health, Columbus, OH

Financial Disclosure: The authors did not report any potential conflicts of interest.

© 2016 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.