Alternate OB & Newborn
INTRODUCTION: Unit Description (Facility) The OB Unit consists of 8 LDRP (Labor-Delivery-Recovery-Postpartum) rooms with a total of 16 available beds (8 mother and 8 newborn), one C-Section Delivery room, two OB Triage rooms, an infant treatment area, and a potential infant isolation area. Additionally, Room #1 can function as a negative air flow isolation room.
An average of 400 deliveries occur annually with the number increasing each year. The unit provides care to outpatient and inpatient obstetrical patients with a gestation of > 20 weeks gestation as well as newborns born in the unit. There is no nursery and babies room-in with the mothers unless they are being observed for a short while or are being stabilized for medevac.
OB Overview
OB Triage Patients
OB WORKFLOW
OB Deliveries
OB Special Circumstances
OB RMT
OB Procedures
Nexplanon:
This is one of the most popular birth control methods postpartum on the OB Unit. It is an insertable 3-year capsule and can only be inserted by a specially trained (and certified) provider. This can usually be arranged for the patient within a 24 hour (or sooner) period.
Induction:
See the new Induction Policy in the NWing Doc’s Office in the “Induction Book.” The YKHC Clinical Guidelines (2011) concerning this are not current.
Episiotomy:
See the same topic above under “Deliveries”
Vacuum assist/extraction:
See the same topic above under “Deliveries”
Repair of Vaginal Delivery Lacerations:
1st and some 2nd degree lacerations may not need repair if hemostasis evident and anatomy is intact (e.g. peri-urethral, vaginal wall).
3rd and 4th degree lacerations repairs usually require HROB presence.
Newborns
Links to page with the following contents:
Newborn Admissions
Scenarios/Special Situations
Newborn Rounding
Newborn Discharge Process
Consults
Transfers/Medevacs (Transfer/medevac section LINK)
As soon as it is obvious that a mom or baby needs to be transferred (in some cases this is before the baby delivers i.e. when there is a known maternal or infant problem that necessitates a NICU or higher level of care for mother and/or infant during labor and/or delivery).
- Call ANMC and get an accepting physician for mom, if she has not delivered, or for baby if baby has delivered…if a patient is non-native the accepting physician should be from Providence NICU.
- Complete the Patient Transport Order (PTO) and other paper work in the transport packet
- Complete the Admit Orders and Medication Reconciliation
- Continue to monitor and stabilize the infant
- Complete the Newborn Discharge/Transfer Summary and add updates as needed. You can create your own transfer template or you can use McClure’s shared template and modify and save it for your own use.
- Update Diagnoses and Problem List
- Complete and E&M charge
- Complete the Medication Reconciliation