Departments of Obstetrics and Gynecology, Women’s Health Services, and Labor and Delivery, Aurora Sinai Medical Center; Aurora UW Medical Group; Center for Urban Population Health; Aurora Research Institute

Presentation Notes

Poster presented at: Aurora Scientific Day; May 22, 2019; Milwaukee, WI.


Background: In October 2016, our health care facility adopted a new classification system for cesarean sections in an effort to have on-time cesarean deliveries among typically unscheduled patients with time-sensitive cesarean sections. Patients with timesensitive cesarean sections include those with an immediate threat to life (emergent) or those with maternal or fetal compromise that is not immediately life threatening (urgent). Even when a cesarean delivery is deemed emergent or urgent (ie, timesensitive), patient-, staff-, anesthesia-, and procedure-related delays may occur.

Purpose: Our quality improvement study aimed to assess whether caregiver education would improve on-time cesarean deliveries.

Methods: We retrospectively studied all emergent (<15 >minutes) and urgent (<30 >minutes) cesarean sections within one labor and delivery unit. Patients 6 months prior to caregiver education were compared with those following nursing and provider education. Nursing and provider education (September 2017–October 2017) focused on development of communication pathways and reorientation to decision-making timelines. To compare groups, descriptive statistics and multivariable linear regression were used to predict time to incision.

Results: A total of 149 patients pre-caregiver education and 185 patients post-caregiver education were included. Patients in the two groups did not differ by age, race/ethnicity, or body mass index (BMI). On univariate analysis, mean time from decision to incision, as well as mean time from decision to anesthesia in patients who did not already have anesthesia initiated, significantly improved (P

Conclusion: Although an improvement in decision-toincision time was observed, it was unrelated to the educational intervention performed. Even so, concurrent nursing education initiatives aimed at improving cesarean section timing may have contributed to on-time emergent and urgent cesarean deliveries. Ultimately, ongoing education and team collaboration should continue in order to further improve cesarean delivery timing and patient care.

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