Purpose of the tool: This tool describes the key perinatal safety elements that support the use of electronic fetal monitoring (EFM). The key safety elements are presented within the framework of the Comprehensive Unit-based Safety Program (CUSP). Who should use this tool: Nurses, physicians, midwives, and labor and delivery (L&D) unit staff responsible for assessment, interpretation, management, communication, and documentation of fetal heart rate patterns and uterine activity observed through EFM. Review the key perinatal safety elements with L&D leadership How to use this tool: and unit staff to determine how the elements will be implemented on your L&D unit. Consider any existing unit procedures, policies, or processes related to the use of EFM to support implementation. Consider existing policies, standing orders, or processes that refer to EFM findings that may need to be updated. Key Perinatal Safety Elements Standardize When Possible (CUSP Science of Safety) Key Perinatal Safety Elements Examples Use standard terminology to The 2008 National Institute for Child Health and describe and document fetal Human Development (NICHD) Workshop heart rate (FHR) and uterine developed nomenclature that has been adopted contraction pattern assessment by several professional organizations as the for all patients who are receiving standard nomenclature for describing FHR and continuous EFM. uterine contraction patterns. Use of the standard NICHD nomenclature for communicating and documenting EFM findings provides a common language for use among providers and staff to decrease variation and provide accurate communication among caregivers. A complete description of an EFM tracing requires a qualitative and quantitative assessment of the following: uterine contractions, baseline FHR, baseline FHR variability, presence of FHR accelerations, periodic or nonperiodic FHR decelerations, and changes in over time. Standardize When Possible (CUSP Science of Safety) (continued) Key Perinatal Safety Elements Examples
Purpose of the tool: This tool describes the key perinatal safety elements that support the use of electronic fetal monitoring (EFM). The key safety elements are presented within the framework of the Comprehensive Unit-based Safety Program (CUSP). Who should use this tool: Nurses, physicians, midwives, and labor and delivery (L&D) unit staff responsible for assessment, interpretation, management, communication, and documentation of fetal heart rate patterns and uterine activity observed through EFM. How to use this tool: Review the key perinatal safety elements with L&D leadership and unit staff to determine how the elements will be implemented on your L&D unit. Consider any existing unit procedures, policies, or processes related to the use of EFM to support implementation. Consider existing policies, standing orders, or processes that refer to EFM findings that may need to be updated. Key Perinatal Safety Elements Standardize When Possible (CUSP Science of Safety) Key Perinatal Safety Elements Examples Use standard terminology to describe and document fetal heart rate (FHR) and uterine contraction pattern assessment for all patients who are receiving continuous EFM. The 2008 National Institute for Child Health and Human Development (NICHD) Workshop developed nomenclature that has been adopted by several professional organizations as the standard nomenclature for describing FHR and uterine contraction patterns. Use of the standard NICHD nomenclature for communicating and documenting EFM findings provides a common language for use among providers and staff to decrease variation and provide accurate communication among caregivers. A complete description of an EFM tracing requires a qualitative and quantitative assessment of the following: uterine contractions, baseline FHR, baseline FHR variability, presence of FHR accelerations, periodic or nonperiodic FHR decelerations, and changes in over time. Standardize When Possible (CUSP Science of Safety) (continued) Key Perinatal Safety Elements Examples
tool_safe-e-fetal-monitoring.docx