| Description |
Background: Unplanned precipitous deliveries in outpatient clinics pose significant challenges to healthcare systems, including the University of Utah healthcare system (UUHC). Despite their rarity, these events require an immediate and effective response to ensure the safety and wellbeing of both mother and newborn. The lack of preparedness among staff members in handling such deliveries has been identified as a critical issue. Local Problem: The UUHC system, encompassing various clinics in Salt Lake City, UT, has experienced approximately one unplanned precipitous out-of-hospital delivery per year in its outpatient clinics, leading to concerns about staff readiness and patient outcomes. Recent events 2 highlighted staff unpreparedness, necessitating the development of a standardized protocol and kit to manage such emergencies effectively. Methods: This Doctor of Nursing Practice (DNP) scholarly project utilized the Johns Hopkins evidence-based practice (EBP) model to adapt and implement a precipitous delivery protocol (PDP) and kit in the Sugarhouse Urgent Care (SHUC) clinic. The study involved pre- and postsurveys to assess staff members' confidence, ability, and preparedness regarding their current practice and the feasibility, usability, and satisfaction of an adapted protocol and kit. Interventions: The PDP and kit were developed through a phased approach involving literature review, multidisciplinary collaboration, protocol adaptation, and approval processes. The protocol outlined roles, responsibilities, and steps for managing a precipitous delivery while the kit contained necessary supplies. Training sessions were conducted for staff members, focusing on protocol implementation and kit utilization. Post-training evaluations assessed feasibility, usability, and satisfaction. Results: Pre- and post-surveys demonstrated significant improvements in staff members' confidence, ability, and preparedness regarding precipitous delivery management (n=18). Feasibility, usability, and satisfaction levels increased post-implementation of the PDP and kit. Qualitative data analysis revealed strong support for the new protocol, with suggestions for further improvement. Conclusion: Implementing the PDP and kit in the SHUC clinic effectively addressed the challenge of unpreparedness for unplanned precipitous deliveries. The project's success, evidenced by improved confidence, ability, preparedness, feasibility, usability, and satisfaction, underscores the importance of standardized protocols and training in outpatient settings. Future efforts could focus on expanding implementation to other urgent care clinics within the UUHC system and conducting further research to assess protocol effectiveness during unplanned OOH deliveries. |
