• cervical assessment;
  • simulation;
  • nursing skills;
  • competency

Poster Presentation

  1. Top of page
  2. Poster Presentation

Purpose for the Program

In a high-risk obstetric department that had 3,600 newborns in 2010, vaginal exams for cervical assessment were routinely performed by residents, attending physicians, and physician assistants employed by the teaching service. Nurse managers in the department were anxious to change this practice, citing the need for labor and delivery nurses to be an active participant in the planning of their patients’ care. This practice also would be an integral part of the Team Performance Plus concept that was being initiated at the hospital.

Proposed Change

The original request was to have the residents teach the nurses and then observe the nurses performing the skill.

Implementation, Outcomes, and Evaluation

Cervical models were made, using directions from a Web site dedicated to education for residents and medical students. An instructional video was also available on this site to provide didactic content for the learners. The simulation lab at the health system was able to purchase a teaching model to also be used in this program. Nursing staff are assigned to this monthly course and are taught by staff experienced in vaginal exams. The nurses view the video, look at models of a cervix at various dilatations, and practice the exams on a clay model that is placed in a paper bag. All of these models have various degrees of dilatation and effacement. The nursing staff are required to be signed off on three patient exams by a physician or resident. A checklist is given to the educator as proof of skill, which is a required competency for 2012. These staff will then be expected to perform exams on their patients. Pre- and posteducation surveys are being completed by staff to determine effectiveness of the training. When all staff have completed the course, there will be an evaluation of how this practice has changed patient outcomes. This course also has been utilized in the simulation lab by the new obstetric residents who entered the hospital's program in July, 2011.

Implications for Nursing Practice

This program shows how health care disciplines can share knowledge about teaching practices and ensure better communication among health care providers.