title: Frequency of nursing, physician and hospital interventions in women at risk for preterm delivery.
abstract: OBJECTIVE
  To determine the frequency of nursing intervention, physician treatment and hospital evaluation for women receiving outpatient management services for preterm labor.
  
  
  METHODS
  Outpatient services included: patient education; daily and as-needed nursing assessment of monitored uterine activity (MUA) and patient symptoms; treatment compliance; and physician notification for values exceeding established limits. We analyzed service data from women with singleton gestations at 20.0-34.9 weeks.
  
  
  RESULTS
  Overall, 307 249 days of data from 10 660 women were reviewed, and 634 983 hours of MUA was assessed. On 53 665 (17.5%) of monitored days, patients exhibited increased MUA and/or symptoms of preterm labor with nursing intervention and reassessment. Physician notification/intervention was required 7316 (13.6%) times, and hospital admission was needed for 3163 (43.2%) of these patients. In the hospital 1400 (44.3%) patients received tocolysis. The mean ( +/- standard deviation) length of hospital stay was 3.2 +/- 7.2 days, and 428 (13.5%) of women remained hospitalized until delivery, with 324 (10.2%) delivering within 48 h.
  
  
  CONCLUSIONS
  In this population of women receiving outpatient preterm-labor management services, 95.1% of excessive MUA or patient-reported symptoms of preterm labor were managed on an outpatient basis. Outpatient management allowed for appropriate identification and triage of women requiring hospital admission.
authors.affiliation: Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, Mississippi 39216, USA.
authors.forename: J C
authors.initials: JC
authors.lastname: Morrison
authors.forename: W E
authors.initials: WE
authors.lastname: Roberts
authors.forename: J S
authors.initials: JS
authors.lastname: Jones
authors.forename: N
authors.initials: N
authors.lastname: Istwan
authors.forename: D
authors.initials: D
authors.lastname: Rhea
authors.forename: G
authors.initials: G
authors.lastname: Stanziano
mesh_terms: D000328:Adult; D016208:Databases, Factual; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D007902:Length of Stay; D009730:Nursing Assessment; D007752:Obstetric Labor, Premature / Q000453:epidemiology* / Q000451:nursing / Q000517:prevention & control*; D010349:Patient Compliance; D010353:Patient Education as Topic; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D011295:Prenatal Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D014218:Triage