title: Developing a Systematic Approach to Obstetric Emergencies.
abstract: OBJECTIVE
  To determine the effect of standardized education specific to maternal resuscitation on nurses' confidence and competence during obstetric emergencies and to determine the cost savings associated with the program.
  
  
  METHODS
  Pre- and postintervention surveys designed to measure perceived confidence and competence in resuscitation before and after Advanced Cardiac Life Support (ACLS) certification in combination with obstetric drills.
  
  
  METHODS
  The project was conducted at a 12-bed labor and delivery, mother/baby unit in an acute care, community-based hospital in Northwest Arkansas.
  
  
  METHODS
  Sixty-seven registered nurses (RNs) who were hospital employees with at least 6 months experience in labor and delivery or the neonatal intensive care unit completed focused education and training.
  
  
  METHODS
  The obstetric ACLS program targeted obstetric emergencies, cardiac arrest in the mother, and simulated drills. Obstetric emergencies included cardiac arrest, postpartum hemorrhage, STAT cesarean, uterine rupture, prolapsed umbilical cord, shoulder dystocia, operative vaginal delivery, and eclampsia.
  
  
  RESULTS
  Comparison of pre- and postassessments revealed improvements in perceived confidence and competence when managing obstetric emergencies. Nurse confidence increased by 35% and nurse competence increased by 32%. The 2-day educational program also realized significant cost savings. Overall costs for the educational program decreased from $94849 to $42974.
  
  
  CONCLUSIONS
  An educationally sound program that included classroom time and focused drills led to increased perceived confidence and competence for nurses and cost savings related to employee education.
authors.forename: Meredith
authors.initials: M
authors.lastname: Green
authors.forename: Carla
authors.initials: C
authors.lastname: Rider
authors.forename: David
authors.initials: D
authors.lastname: Ratcliff
authors.forename: Barbara C
authors.initials: BC
authors.lastname: Woodring
mesh_terms: D000328:Adult; D001131:Arkansas; D002983:Clinical Competence; D036861:Delivery, Obstetric / Q000451:nursing; D004509:Education, Nursing, Continuing / Q000379:methods*; D004630:Emergencies; D004632:Emergency Medical Services / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration*; D017283:Neonatal Nursing / Q000193:education / Q000379:methods*; D024802:Nurse's Role; D007744:Obstetric Labor Complications / Q000451:nursing* / Q000517:prevention & control; D010348:Patient Care Team / Q000458:organization & administration; D011247:Pregnancy; D015397:Program Evaluation; D055815:Young Adult
keywords: Advanced Cardiac Life Support in pregnancy; cardiac arrest; nurse competence; nurse confidence; obstetric emergencies