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How-to Guide: Prevent Obstetrical Adverse Events

Last Modified: 11/09/2012

​Institute for Healthcare Improvement

Cambridge, Massachusetts, USA

 

How to cite this document:

How-to Guide: Prevent Obstetrical Adverse Events. Cambridge, MA: Institute for Healthcare Improvement; 2012. (Available at www.ihi.org).

 

This How-to Guide describes the essentials elements of preventing obstetrical adverse events, including the safe use of oxytocin and key evidence-based care components in the IHI Perinatal Bundles: IHI Elective Induction Bundle (Oxytocin), IHI Augmentation Bundle (Oxytocin), and the IHI Vacuum Bundle. The guide describes how to implement these interventions and recommends measures to gauge improvement.

 

The content of this How-to Guide was developed through the work of faculty and participants in the IHI Perinatal Improvement Community.

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    When the OB nurses at Woman’s Hospital in Baton Rouge noticed full-term births were becoming disturbingly rare, they took action. Their commitment to make a difference eventually helped decrease the hospital's NICU admissions by 23 percent, and informed a statewide birthing initiative that has made Louisiana a leader in perinatal care.
  • Using Care Bundles to Improve Health Care Quality
    This IHI white paper describes the history, theory of change, design concepts, and outcomes associated with the development and use of bundles — a small set of evidence-based interventions for a defined patient population and care setting — and reflects on learning over the past decade.
  • Perinatal Ticket to Discharge
    This communication tool is given to patients by maternity center staff to help guide educational discussions and to provide a "to do" list of items that need to be completed prior to discharge from the hospital.

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  • IHI Perinatal Trigger Tool
    The Perinatal Trigger Tool provides instructions for conducting a retrospective review of patient records using triggers to identify possible adverse events causing any physical harm to the infant or mother.
  • Using Care Bundles to Improve Health Care Quality
    This IHI white paper describes the history, theory of change, design concepts, and outcomes associated with the development and use of bundles — a small set of evidence-based interventions for a defined patient population and care setting — and reflects on learning over the past decade.

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