Obstetric Epidural Time-Outs: Will this Promote Patient Safety and Improve Staff Communication? A Quality Improvement Project

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Introduction: Anesthesia providers face daily challenges when caring for patients in non-operating room anesthesia (NORA) sites that require non-surgical, invasive procedures. The Joint Commission (TJC) also requires all “surgical and non-surgical invasive procedures” to have a completed safety checklist prior to starting the procedure. Purpose: The goal of this project was to investigate if an obstetric epidural time-out tool would promote patient safety and increase pre-procedure staff communication. Method: A quantitative study that assessed safety time-outs and an obstetrical epidural time-out tool on the Labor and Delivery room (LDR) unit at a community hospital in the Midwest. Results: A pre-intervention questionnaire and information session to launch the study tool were used to obtain a baseline understanding of safety time-outs. A post-intervention questionnaire assessed the OB RNs’ increased knowledge at the end of the study. The mean score of the pre and post questionnaire improved from 74.6% to 80%. The 6-week study evaluated the overall completion percentage of the time-out tool. Of the 53 tools returned out of 113, there was an 87.812 mean compliance rate that had 100% of the 10-check boxes completed. Discussion: Non-surgical invasive procedures are performed in various areas of the hospital. The LDR unit should also adhere to TJC’s safety standards during epidural placement.

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Anesthesia, Closed claims, Complications, Epidural, Neuraxial, Adverse effects, Time-outs, Safety, Lawsuit
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