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.

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