“Care Bundle” Strategies – A Way To Decrease Birth Injuries

“Care Bundle” StrategiesIf you would look at the state of delivery rooms on hospitals, you will see that it has become advanced in terms of handling infants. However, what you may not know is that, contrary to what you may see on hospitals, most birth injuries, including major ones, occur here. Most of these injuries occur due to simple communication problems.

It is normal for us to trust our doctors. It is because, after all, they know what they are doing. Even when faced with high amounts of stress, they are expected to do everything right, even on times like birthing and labor.

However, this is not true. One study shows that teamwork between doctors and nurses diminish after stress takes over. The diminished teamwork causes a major threat to the unborn infant more than anything else, as the stress may cause them to keep track of their duties, especially for a hospital that handles thousands of patients in a single day.

In 2008, 16 hospitals formed the “Premier Alliance”, which attempts to correct that image of hospital doctors and nurses, particularly those who handle labor. The “Premier Alliance” attempt to correct this by using what is called “care bundles”. Care bundles are a series of protocols followed whenever labor occurs. These care bundles are best used when on a team. When done properly, it can reduce the stress between doctors and nurses, thus ensuring the safe birth of the baby.

“We want to make sure that care is properly delivered, so that the birth process will be more effective,” as said by Susan DeVore, the Premier Alliance’s chief operating officer.“Our goal is to make sure that the injury rate is as close to zero as possible, as zero is only the acceptable number.”

Care bundles apply to all birth situations, but they are most commonly used on two events: the decision if pitocin should be used or not to induce labor, and the use of vacuum extractors should the process of labor prove to be harder.

Should a case of vacuum extraction birth happen, the “care bundle” would include:

  • Discussion between the doctor and the patient. The doctor will let the patient know about the process, as well as the risks involved in it.
  • Complete documentation of the above discussion.
  • An exam to make sure that the baby is properly positioned.
  • A backup plan for emergency staffers to be always ready and on call, should there be a problem with the birthing process.

On a recent Wall Street Journal article, the Premier Alliance has successfully decreased birth injuries – around eleven percent – and is continuing to drop due to its care bundle programs. Not only that, the number of babies who were born with insufficient oxygen were reduced by 31 percent.

Recently, the Federal government has given and awarded $3 million each to two groups who improved obstetrical safety – Ascension Health, which is based on St. Louis, and Fairview Health Services, which is based on Minneapolis.

“I have a mental checklist now of what to do,” said Dr. Paul Burstein, a resident doctor on Ascension Health in St. Louis. “It’s given me more confidence. And I know other members of the team are on the same page.”