OBSTETRIC NURSING MANAGER


REQUIRED QUESTIONS

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  1. Is a physician with appropriate privileges available during regional anesthetics to manage anesthetic complications until the patient's post-anesthesia condition is satisfactory and stable?
  2. Do all patients recovering from regional anesthesia receive appropriate post-anesthesia care? Following cesarean delivery and/or extensive regional blockade, are the ASA standards for post-anesthesia care applied?
  3. Is an intravenous infusion established before the initiation of regional anesthesia and maintained throughout the duration of the regional anesthetic?
  4. Is there a licensed practitioner privileged to administer an appropriate anesthetic and maintain support of vital functions in any obstetric emergency available? Is there a required pre-anesthesia exam performed by a qualified anesthesiologist (or other physician if no anesthesiologist is available?)
  5. Does the anesthesia department strive to provide a response time for emergent C-section consistent with the Joint ASA-ACOG Optimal Goals for C-section response? (Currently 30 minutes from decision/notification of anesthesiologist to incision.)
  6. Is there a policy requiring the immediate availability of appropriate facilities and personnel, including obstetric anesthesia, nursing personnel, and a physician capable of monitoring labor and performing an emergency cesarean delivery, in cases of trial of labor after cesarean delivery (TOLAC)? (The definition of immediately available personnel and facilities remains a local decisions based on each institution's available resources and geographic location.)
  7. Is safety the top priority in the anesthesia department?
  8. Is there open and effective collegial communication between your service and the anesthesia department?
  9. Are there qualified personnel (other than the anesthesiologist attending the mother) immediately available to assume responsibility for neonatal resuscitation?
  10. Is there a policy to assure the availability of a physician to manage labor anesthetic complications and to provide cardiopulmonary resuscitation for patients receiving post-anesthesia care?

OPTIONAL QUESTIONS

  1. Does the department provide an average response time of less than 20 minutes with a maximum response time of less than 1 hour for epidural requests?
  2. Is there documentation of mock code practice in obstetrics?
  3. Is a designated anesthesiologist appointed as a liaison to the OB department?
  4. If requested, does the anesthesia department offer educational opportunities for your staff?
  5. Does the department of anesthesia have standard order-sets in place?
  6. Is the response time to most pages to the department of anesthesia timely?
  7. Are pencil-point needles the usual spinal needle utilized in OB regional anesthesia?

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