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Keywords:

  • EXIT;
  • algorithm of care;
  • multidisciplinary team members;
  • EXIT checklist

Poster Presentation

  1. Top of page
  2. Poster Presentation

Purpose for the Program

To provide information on the Ex Utero Intrapartum Treatment (EXIT) procedure and develop standards of care to ensure that the multidisciplinary perioperative team provides excellent patient care during the EXIT procedure by using the TEAM approach:

  • T-Multidisciplinary team using the latest technology.
  • E-Evidence-based practice.
  • A-Utilization of Association of Perioperative Registered Nurses standards.
  • M-Highest quality of care for mother and infant.

Proposed Change

Because the EXIT procedure was a new procedure, a plan of care had to be created. Each procedure has a unique set of patient-specific, clinical needs. The role of each multidisciplinary member needed to be defined. Perioperative nurses collaborated with members of the multidisciplinary team to define the role of each member. This included staff nurses from the departments of labor and delivery, surgery, and neonatal intensive care unit (NICU). There was also a need to develop clinical guidelines and protocols and to educate the staff. Preprocedure briefing and postprocedure briefing were planned.

Implementation, Outcomes, and Evaluation

  • A preprocedure briefing was held 1 to 2 hours prior to the start of the procedure.
  • All the representatives from each discipline were in attendance.
  • A perioperative EXIT supply checklist was developed by the team for ensuring that all the necessary supplies were available at the time of the procedure.
  • All members of the EXIT team were briefed and educated on the preprocedure checklist and how it is utilized. Furthermore, the members were informed that scrutiny of this checklist will be ongoing.

All the equipment was readily available for use during the actual procedure. Through the process of team building and education, the perioperative team members had an increased understanding of other team members’ roles. A postprocedure debriefing was held to review the supplies used and add additional information as needed for future cases.

Implications for Nursing Practice

Each EXIT procedure performed provides the opportunity to improve patient care and provide new information to our colleagues regarding our increased knowledge in this unique area. The algorithm of care established was hysterectomy, fetal airway assessment, direct laryngoscope, airway suctioning, view of vocal cords, rigid or flexible bronchoscope, intubation or tracheostomy, application of pulse oximeter, and fetal heart monitor or electrocardiogram.