Oxytocin, excessive uterine activity, and patient safety: time for a collaborative approach.
Oxytocin use for induction or augmentation of labor is a common occurrence in labor and delivery, as well as a common source of conflict between obstetric providers and nurses. Allegations regarding inappropriate oxytocin use and excessive uterine activity arise in obstetric litigation in both the United States and abroad, and oxytocin was recently added to the Institute for Safe Medical Practices list of high-alert medications, making oxytocin administration a significant risk management issue. Current efforts at standardization of terminology related to uterine activity, recent research on the relationship of excessive uterine activity to fetal oxygenation and outcome, and clinical success with adoption of standardized oxytocin administration provide clinicians with evidence to create a structured, collaborative approach to oxytocin administration in labor. This article provides a brief overview of relevant literature and suggests strategies for the implementation of such a collaborative approach.
Miller
Lisa A
LA
Perinatal Risk Management and Education Services, St Anthony Hospital, Chicago, Illinois 60618, USA. LisaCNM@comcast.net
D000328:Adult; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000009:adverse effects* / Q000451:nursing; D019300:Medical Errors / Q000517:prevention & control; D017283:Neonatal Nursing / Q000458:organization & administration*; D010120:Oxytocics / Q000009:adverse effects; D010121:Oxytocin / Q000008:administration & dosage / Q000009:adverse effects*; D019555:Physician-Nurse Relations; D011247:Pregnancy; D012308:Risk Management / Q000458:organization & administration; D017751:Safety Management / Q000458:organization & administration*; D017749:Total Quality Management / Q000458:organization & administration; D014590:Uterine Contraction / Q000187:drug effects
D010120:Oxytocics; D010121:Oxytocin