Intervention for fetal distress among obstetricians, registered nurses, and residents

Similarities, differences, and determining factors

Giuseppe Chiossi, Maged Costantine, Joy M. Pfannstiel, Gary Hankins, George Saade, Zhao Helen Wu

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective: To explore the factors possibly associated with the intrapartum management of nonreassuring fetal status and the factors affecting the decision to expedite delivery for fetal distress among different obstetric health care providers. Methods: In a cross-sectional study, a standardized hypothetical clinical scenario of management of fetal distress was presented by a study investigator to labor and delivery personnel, including faculty obstetricians, residents, and registered nurses (N=52). An intervention index was calculated for each faculty by dividing the number of cesarean and operative deliveries for nonreassuring fetal status by the actual number of laboring patients supervised by each faculty in 2008. Results: Selection of the timing of delivery and characterization of nonreassuring fetal heart rate patterns was not different among the different providers (P=.3). However, compared with residents, registered nurses notified the attending obstetricians at an earlier stage and in response to different fetal heart rate tracing scenarios suggestive of fetal distress (P<.001). Personal or professional experience, type of clinical practice, and psychological traits did not affect the management of the standardized clinical scenario or the intervention index (P=.3-.9). Conclusion: Different providers practicing in the same environment may develop a similar approach in the setting of nonreassuring fetal status that overcomes individual differences and follows the current guidelines on electronic fetal monitoring.

Original languageEnglish (US)
Pages (from-to)809-817
Number of pages9
JournalObstetrics and Gynecology
Volume118
Issue number4
DOIs
StatePublished - Oct 2011

Fingerprint

Fetal Distress
Nurses
Fetal Heart Rate
Cardiotocography
Individuality
Health Personnel
Obstetrics
Cross-Sectional Studies
Research Personnel
Guidelines
Psychology

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Intervention for fetal distress among obstetricians, registered nurses, and residents : Similarities, differences, and determining factors. / Chiossi, Giuseppe; Costantine, Maged; Pfannstiel, Joy M.; Hankins, Gary; Saade, George; Wu, Zhao Helen.

In: Obstetrics and Gynecology, Vol. 118, No. 4, 10.2011, p. 809-817.

Research output: Contribution to journalArticle

Chiossi, Giuseppe ; Costantine, Maged ; Pfannstiel, Joy M. ; Hankins, Gary ; Saade, George ; Wu, Zhao Helen. / Intervention for fetal distress among obstetricians, registered nurses, and residents : Similarities, differences, and determining factors. In: Obstetrics and Gynecology. 2011 ; Vol. 118, No. 4. pp. 809-817.
@article{a374b2b97c2c4206abddea9ac2d9399e,
title = "Intervention for fetal distress among obstetricians, registered nurses, and residents: Similarities, differences, and determining factors",
abstract = "Objective: To explore the factors possibly associated with the intrapartum management of nonreassuring fetal status and the factors affecting the decision to expedite delivery for fetal distress among different obstetric health care providers. Methods: In a cross-sectional study, a standardized hypothetical clinical scenario of management of fetal distress was presented by a study investigator to labor and delivery personnel, including faculty obstetricians, residents, and registered nurses (N=52). An intervention index was calculated for each faculty by dividing the number of cesarean and operative deliveries for nonreassuring fetal status by the actual number of laboring patients supervised by each faculty in 2008. Results: Selection of the timing of delivery and characterization of nonreassuring fetal heart rate patterns was not different among the different providers (P=.3). However, compared with residents, registered nurses notified the attending obstetricians at an earlier stage and in response to different fetal heart rate tracing scenarios suggestive of fetal distress (P<.001). Personal or professional experience, type of clinical practice, and psychological traits did not affect the management of the standardized clinical scenario or the intervention index (P=.3-.9). Conclusion: Different providers practicing in the same environment may develop a similar approach in the setting of nonreassuring fetal status that overcomes individual differences and follows the current guidelines on electronic fetal monitoring.",
author = "Giuseppe Chiossi and Maged Costantine and Pfannstiel, {Joy M.} and Gary Hankins and George Saade and Wu, {Zhao Helen}",
year = "2011",
month = "10",
doi = "10.1097/AOG.0b013e31822e00bc",
language = "English (US)",
volume = "118",
pages = "809--817",
journal = "Obstetrics and Gynecology",
issn = "0029-7844",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Intervention for fetal distress among obstetricians, registered nurses, and residents

T2 - Similarities, differences, and determining factors

AU - Chiossi, Giuseppe

AU - Costantine, Maged

AU - Pfannstiel, Joy M.

AU - Hankins, Gary

AU - Saade, George

AU - Wu, Zhao Helen

PY - 2011/10

Y1 - 2011/10

N2 - Objective: To explore the factors possibly associated with the intrapartum management of nonreassuring fetal status and the factors affecting the decision to expedite delivery for fetal distress among different obstetric health care providers. Methods: In a cross-sectional study, a standardized hypothetical clinical scenario of management of fetal distress was presented by a study investigator to labor and delivery personnel, including faculty obstetricians, residents, and registered nurses (N=52). An intervention index was calculated for each faculty by dividing the number of cesarean and operative deliveries for nonreassuring fetal status by the actual number of laboring patients supervised by each faculty in 2008. Results: Selection of the timing of delivery and characterization of nonreassuring fetal heart rate patterns was not different among the different providers (P=.3). However, compared with residents, registered nurses notified the attending obstetricians at an earlier stage and in response to different fetal heart rate tracing scenarios suggestive of fetal distress (P<.001). Personal or professional experience, type of clinical practice, and psychological traits did not affect the management of the standardized clinical scenario or the intervention index (P=.3-.9). Conclusion: Different providers practicing in the same environment may develop a similar approach in the setting of nonreassuring fetal status that overcomes individual differences and follows the current guidelines on electronic fetal monitoring.

AB - Objective: To explore the factors possibly associated with the intrapartum management of nonreassuring fetal status and the factors affecting the decision to expedite delivery for fetal distress among different obstetric health care providers. Methods: In a cross-sectional study, a standardized hypothetical clinical scenario of management of fetal distress was presented by a study investigator to labor and delivery personnel, including faculty obstetricians, residents, and registered nurses (N=52). An intervention index was calculated for each faculty by dividing the number of cesarean and operative deliveries for nonreassuring fetal status by the actual number of laboring patients supervised by each faculty in 2008. Results: Selection of the timing of delivery and characterization of nonreassuring fetal heart rate patterns was not different among the different providers (P=.3). However, compared with residents, registered nurses notified the attending obstetricians at an earlier stage and in response to different fetal heart rate tracing scenarios suggestive of fetal distress (P<.001). Personal or professional experience, type of clinical practice, and psychological traits did not affect the management of the standardized clinical scenario or the intervention index (P=.3-.9). Conclusion: Different providers practicing in the same environment may develop a similar approach in the setting of nonreassuring fetal status that overcomes individual differences and follows the current guidelines on electronic fetal monitoring.

UR - http://www.scopus.com/inward/record.url?scp=80053377813&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80053377813&partnerID=8YFLogxK

U2 - 10.1097/AOG.0b013e31822e00bc

DO - 10.1097/AOG.0b013e31822e00bc

M3 - Article

VL - 118

SP - 809

EP - 817

JO - Obstetrics and Gynecology

JF - Obstetrics and Gynecology

SN - 0029-7844

IS - 4

ER -