title: Improving Interprofessional Consistency in Electronic Fetal Heart Rate Interpretation.
abstract: Objective To determine if mandatory online training in electronic fetal monitoring (EFM) improved agreement in documentation between obstetric care providers and nurses on labor and delivery. Methods Health care professionals working in obstetrics at our institution were required to complete a course on EFM interpretation. We performed a retrospective chart review of 701 charts including patients delivered before and after the introduction of the course to evaluate agreement among providers in their documentation of their interpretations of the EFM tracings. Results Agreement between provider and nurse documentation at the time of admission improved for variability and accelerations (variability: 91.1 vs. 98.3%, p < 0.001; and accelerations: 75.2 vs. 87.7%, p < 0.001). Similarly, agreement improved at the time of the last note prior to delivery for documentation of variability and accelerations (variability: 82.1 vs. 90.6%, p = 0.001; and accelerations: 56.7 vs. 68.6%, p = 0.0012). Agreement in interpretation of decelerations both at the time of admission and at the time of delivery increased (86.3 vs. 90.6%, p = 0.0787, and 56.7 vs. 61.1%, p = 0.2314, respectively) but was not significant. Conclusion An online EFM course can significantly improve consistency in multidisciplinary documentation of fetal heart rate tracing interpretation.
authors.affiliation: Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, New York.
authors.forename: Shravya
authors.initials: S
authors.lastname: Govindappagari
authors.affiliation: Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York.
authors.forename: Sahar
authors.initials: S
authors.lastname: Zaghi
authors.affiliation: Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York.
authors.forename: Ferdous
authors.initials: F
authors.lastname: Zannat
authors.affiliation: Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York.
authors.forename: Laura
authors.initials: L
authors.lastname: Reimers
authors.affiliation: Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York.
authors.forename: Dena
authors.initials: D
authors.lastname: Goffman
authors.affiliation: Hospitals Insurance Company, New York, New York.
authors.forename: Irene
authors.initials: I
authors.lastname: Kassel
authors.affiliation: Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York.
authors.forename: Peter S
authors.initials: PS
authors.lastname: Bernstein
mesh_terms: D015148:Cardiotocography / Q000379:methods*; D003627:Data Interpretation, Statistical; D004282:Documentation / Q000706:statistics & numerical data*; D005260:Female; D006340:Heart Rate, Fetal / Q000502:physiology*; D006801:Humans; D007400:Interprofessional Relations; D009774:Obstetrics / Q000193:education*; D011247:Pregnancy; D012189:Retrospective Studies