Infusing Evidence-Based Practice Into Interdisciplinary Perinatal Morbidity and Mortality Conferences

Hiner, Jacqueline B.; White, Sharon; Fields, Willa

doi:10.1097/jpn.0b013e3181af6ebb

Cited by 9 publications

(5 citation statements)

References 15 publications

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“…71 Recommendation: Do Not Just Talk the Talk, Walk the Walk-Allocate Ample Time for Actionable Plan Development Change requires clinicians take a sleeves-up approach to partner with educators and administrators to examine and develop new processes and policies and to champion improvement initiatives throughout all phases of the plan: roll-out implementation and integration into practice. 72 Effective action plans should include four fundamental components: (1) identify a succinct, actionable intervention; (2) assign accountability (i.e., administrators and frontline providers responsible for tasks); (3) include completion target time frames; and (4) track and update all on the status of the intervention and the time frame. 3,12 Achieving substantial change requires small, specific, yet incremental adjustments that can lead to substantial, effective alterations.…”

Section: Challenge 5: Mmcs Examine Problems and Provide Recommendatio...mentioning

confidence: 99%

The Morbidity and Mortality Conference: Opportunities for Enhancing Patient Safety

et al. 2020

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Since the 20th century, health care institutions have used morbidity and mortality conferences (MMCs) as a forum to discuss complicated cases and fatalities to capitalize on lessons learned. Medical technology, health care processes, and the teams who provide care have evolved over time, but the format of the MMC has remained relatively unchanged. The present article outlines 5 key areas for improvement within the MMC along with prescriptive and actionable recommendations for mitigating these challenges. This work incorporates the contributions of numerous researchers and practitioners from the educational, training, debrief, and health care fields. With the best practices and lessons learned from various domains in mind, we recommend optimizing the MMC by (1) encouraging a culture that leverages expertise from multiple sources, (2) allocating ample time for innovative thinking, (3) using a global approach that considers individual, team, and system-level factors, (4) leveraging learnings from errors as well as near misses, and (5) promoting communication, innovative thinking, and actionable planning. The 5 evidence-based recommendations herein serve to ensure that MMCs are structured learning events that promote, encourage, and support safe, reliable care. Furthermore, the outlined recommendations seek to capitalize upon the MMC's opportunity to engage early discovery as well as proactive risk assessment and action-oriented solutions.B ecause of the prevalence of adverse events, the health care sector has made efforts to improve patient safety and quality care. The morbidity and mortality conference (MMC) is a forum to improve patient care through the disclosure and review of error and near-miss events by analyzing errors to gain insights and extract knowledge to improve care processes and outcomes. 1,2 To elaborate further, MMCs are traditionally regularly scheduled meetings in which select patient case studies and provider-raised issues are reviewed to (1) determine the appropriateness and evidence-base of the clinical provision of care when weighed against accepted best practices, (2) learn from patient cases where errors and complications occurred, and (3) determine whether future errors can be prevented or mitigated by adjusting actions and judgments. [3][4][5][6] Morbidity and mortality conferences are similar to debriefs (i.e., a forum of reflection and planning to improve performance 7 ); that is, participants in debriefs as well as MMCs reflect on a previous experience or case to identify actions, construct meaning, and uncover lessons that can be applied to improve outcomes. 7 Similar to MMCs, properly executed debriefs can improve performance of individuals and teams but only if they achieve their desired objectives. 7 Morbidity and mortality conferences are designed to educate the disciplines based on the experiences of a select, unfortunate few. 8,9 This education, ideally, leads to positively changed clinical practice, 10 and some advocate for increasing the frequency of the MMC. 11 Across health...

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Section: Challenge 5: Mmcs Examine Problems and Provide Recommendatio...mentioning

confidence: 99%

The Morbidity and Mortality Conference: Opportunities for Enhancing Patient Safety

et al. 2020

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“…Nurses can take initiative in planning pre‐admission interdisciplinary care conferences for high‐risk patients. Care plans can then be developed to address patient needs, potential complications and identify the need for specialized equipment or staff (Hiner, White, & Fields, ). Retrospectively, nursing grand rounds can present unique high‐risk cases providing an avenue for process improvement.…”

Section: Resultsmentioning

confidence: 99%

Postpartum Care of a Woman with Cerebral Palsy and Deep Vein Thrombosis

Phillips¹,

Bulmer²

2012

Nursing for Women's Health

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“…1 Although the American College of Obstetrics and Gynecology have a recommended protocol for oxytocin administration, it is not unusual for hospitals to use multiple individual provider preferences for its administration. Multiple studies with different doses of oxytocin were found but lacked direct comparison in randomized trials.…”

Section: Oxytocin Administrationmentioning

confidence: 99%

Routine Obstetrical Interventions

James¹

2011

Journal of Perinatal &Amp; Neonatal Nursing

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There are many interventions performed as a part of the active management of labor and birth that have remained unchanged over the years. Separating ritual from beneficial nursing care can guide the development of a research agenda. The agenda for the next 10 years can address some of the gaps remaining in the evidence-based foundation for routine interventions used during labor and birth. The gaps identify areas where unanswered questions prevent optimal care from occurring. These unanswered questions include optimal time for epidural administration; management of maternal movement during labor when routine interventions make this difficult; changing the practice of immediate, closed glottis coached pushing at 10 cm; continuous electronic fetal monitoring; routine administration of intravenous fluids; and finally, the use of oxytocin as augmentation or induction of labor.

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Infusing Evidence-Based Practice Into Interdisciplinary Perinatal Morbidity and Mortality Conferences

Cited by 9 publications

References 15 publications

The Morbidity and Mortality Conference: Opportunities for Enhancing Patient Safety

The Morbidity and Mortality Conference: Opportunities for Enhancing Patient Safety

Postpartum Care of a Woman with Cerebral Palsy and Deep Vein Thrombosis

Routine Obstetrical Interventions

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