Purpose for the Program
Pregnant patients frequently call obstetric triage to speak with nurses to obtain obstetric advice in regarding their pregnancies and impending labors. Nurses were providing a variety of responses, and many were not documenting their instructions during these phone calls. It not only created a liability for the hospital and the triage nurses, but it also created a safety issue for the patients on the phone. It became clear that an evidence-based process needed to be put in place to guide nurses’ telephone assessments for obstetric patients.
To develop a telephone triage process that provides nurses with algorithms and standard documentation to utilize during patient calls to obstetric triage. This process will help to ensure that advice remains consistent among the nurses and will correlate with system standardized discharge instructions.
Implementation, Outcomes, and Evaluation
The current obstetric telephone triage process was put into practice in June 2009. A standardized documentation form was developed for effective and efficient documentation of calls. Standardized algorithms were made available to nurses to reference for phone assessment and to provide advice based on the type of patient complaint that was provided. Since implementation, staff have demonstrated a significant increase in documentation adherence. Banner Thunderbird Medical Center obstetric triage nurses who voluntarily took an anonymous survey reported they agreed that the ability of obstetric triage nurses to provide safe patient care to telephone triage patients has been improved since the implementation of the obstetric telephone triage process.
Implications for Nursing Practice
The Banner Thunderbird Medical Center obstetric telephone triage process is supported by peer-reviewed literature, as well as statements by the American College of Obstetricians and Gynecologists and the Association of Women's Health, Obstetric and Neonatal Nurses. Nursing adherence with documentation of obstetric telephone triage phone calls has improved significantly since the implementation of the process. Nurses perceive a greater reduction of risk for the hospital and themselves and agree that they are able to provide safer patient care as a result of the process implementation.