OBSTETRIC NURSING MANAGER
REQUIRED QUESTIONS
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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?
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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?
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Is an intravenous infusion established before the initiation of regional anesthesia and maintained throughout the duration of the regional anesthetic?
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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?)
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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.)
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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.)
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Is safety the top priority in the anesthesia department?
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Is there open and effective collegial communication between your service and the anesthesia department?
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Are there qualified personnel (other than the anesthesiologist attending the mother) immediately available to assume responsibility for neonatal resuscitation?
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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
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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?
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Is there documentation of mock code practice in obstetrics?
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Is a designated anesthesiologist appointed as a liaison to the OB department?
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If requested, does the anesthesia department offer educational opportunities for your staff?
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Does the department of anesthesia have standard order-sets in place?
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Is the response time to most pages to the department of anesthesia timely?
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Are pencil-point needles the usual spinal needle utilized in OB regional anesthesia?
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