Documents

READINESS

BirthTOOLS.org - a website offering a toolkit of evidence based practices to support physiologic birth.  The toolkit was created by the American College of Nurse Midwives and Childbirth Connection, along with representatives from Association of Women’s Health, obstetric and neonatal nurses, National Association of Certified Professional Midwives and Lamaze International.

Childbirth Connection, Hormonal Physiology of Childbearing:  Fact Sheets on Core Topics  - this set of fact sheets from Childbirth Connection outlines hormonal changes through the process of labor and delivery, highlighting how to support hormonal changes during non-physiologic birth.

Maternal preference for cesarean delivery - do women get what they want?  - this article discusses the association between maternal preference for cesarean delivery and the actual mode of delivery experienced.  Women who preferred a cesarean delivery were more likely to ultimately deliver via cesarean section.  Education to address concerns regarding vaginal delivery are important in reducing primary and overall rates of cesarean section.

Low-risk, primary cesarean births in Medicaid:  National Association of Medicaid Directors/Association of Maternal and Child Health Programs Issue Brief 2015  - this brief outlines several strategies for Medicaid payment approaches with providers to decrease the primary and overall cesarean delivery rate.  Realizing that multiple approaches will be required to successfully decrease cesarean deliveries, partnerships between state agencies are also explored.

Consequences of a primary elective cesarean delivery across the reproductive life  - this article measured maternal morbidity associated with elective primary cesarean delivery versus a trial of labor.  Measured complications of delivery included transfusion, operative injury, deep venous thrombosis, hysterectomy and death. 

Safe reduction of the primary cesarean delivery  - this consensus statement by the American College of Obstetricians and Gynecologists discusses the indications for cesarean delivery, the risks of adverse maternal and neonatal outcomes by mode of delivery, the cesarean delivery rates across the United States, and offers guidance on clinical management in each stage of labor to reduce cesarean deliveries.  The initial statement was published in 2014 and reaffirmed in 2016. 

 

RECOGNITION

BirthTOOLS.org - a website offering a toolkit of evidence based practices to support physiologic birth.  The toolkit was created by the American College of Nurse Midwives and Childbirth Connection, along with representatives from Association of Women’s Health, obstetric and neonatal nurses, National Association of Certified Professional Midwives and Lamaze International.

AWHONN Women’s Health and Perinatal Nursing Care Quality Refined Draft Measures Specifications  - the draft, released in 2014, defines nursing care quality measures defined by AWHONN to improve care provided to women and children.

Primary Cesarean Delivery in the United States  - this article describes a large retrospective cohort study examining indications for primary cesarean section and highlights opportunities to lower the primary cesarean rate and thus the total cesarean rate.

CRICO Clinical Guidelines for Obstetrical Services - Guideline 15:  Assessment and Monitoring in Labor and Delivery  - this document provides guidelines for the clinical provider to include admission to labor and delivery, initial evaluation of the patient and continues through first and second stages of labor and delivery of the infant.  Also included are guidelines for patient education during and after labor and delivery.

Cesarean deliveries, outcomes and opportunities for change in California:  Toward a public agenda for maternity care safety and quality  - this white paper provides an in-depth summary of the practices behind the rising cesarean delivery rates in California.  The summary provides recommendations for decreasing cesarean delivery rates to include quality improvement, payment reform and education that can be implemented effectively in any state.

Preventing the First Cesarean Delivery:  Summary of a Joint Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal- Fetal Medicine, and American College of Obstetricians and Gynecologists Workshop - this article summarizes the content and discussion provided at a workshop supported by the National Institute of Child Health and Human Development, the Society for Maternal-Fetal Medicine, and the American College of Obstetricians and Gynecologists on preventing primary cesarean delivery.  The discussion includes indications for delivery, labor management practices, diagnosis of arrest disorders, operative vaginal delivery, evaluation of fetal status before and during labor, and non-medical factors contributing to primary cesarean delivery.  Algorithms for the management of induction of labor, assessment of intrapartum fetal heart rate monitoring and spontaneous labor are included. 

 

RESPONSE

BirthTOOLS.org - a website offering a toolkit of evidence based practices to support physiologic birth.  The toolkit was created by the American College of Nurse Midwives and Childbirth Connection, along with representatives from Association of Women’s Health, obstetric and neonatal nurses, National Association of Certified Professional Midwives and Lamaze International.

AWHONN Women’s Health and Perinatal Nursing Care Quality Refined Draft Measures Specifications  - the draft, released in 2014, defines nursing care quality measures defined by AWHONN to improve care provided to women and children.

Primary Cesarean Delivery in the United States  - this article describes a large retrospective cohort study examining indications for primary cesarean section and highlights opportunities to lower the primary cesarean rate and thus the total cesarean rate.

CRICO Clinical Guidelines for Obstetrical Services - Guideline 15:  Assessment and Monitoring in Labor and Delivery - this document provides guidelines for the clinical provider to include admission to labor and delivery, initial evaluation of the patient and continues through first and second stages of labor and delivery of the infant.  Also included are guidelines for patient education during and after labor and delivery.

Labor and delivery teamwork leads to fewer cesareans  - this article describes the collaborative practice experience between midwifery, laborists and obstetricians at a hospital in California at the Society for Maternal-Fetal Medicine 2015 Annual Pregnancy Meeting.  This model was able to demonstrate a decline in the rate of cesarean delivery for nulliparous women and an increase in the rate of vaginal birth after cesarean delivery.

Cesarean deliveries, outcomes and opportunities for change in California:  Toward a public agenda for maternity care safety and quality  - this white paper provides an in-depth summary of the practices behind the rising cesarean delivery rates in California.  The summary provides recommendations for decreasing cesarean delivery rates to include quality improvement, payment reform and education that can be implemented effectively in any state.

Safe reduction of the primary cesarean delivery  - this consensus statement by the American College of Obstetricians and Gynecologists discusses the indications for cesarean delivery, the risks of adverse maternal and neonatal outcomes by mode of delivery, the cesarean delivery rates across the United States, and offers guidance on clinical management in each stage of labor to reduce cesarean deliveries.  The initial statement was published in 2014 and reaffirmed in 2016. 

Preventing the First Cesarean Delivery:  Summary of a Joint Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal- Fetal Medicine, and American College of Obstetricians and Gynecologists Workshop - this article summarizes the content and discussion provided at a workshop supported by the National Institute of Child Health and Human Development, the Society for Maternal-Fetal Medicine, and the American College of Obstetricians and Gynecologists on preventing primary cesarean delivery.  The discussion includes indications for delivery, labor management practices, diagnosis of arrest disorders, operative vaginal delivery, evaluation of fetal status before and during labor, and non-medical factors contributing to primary cesarean delivery.  Algorithms for the management of induction of labor, assessment of intrapartum fetal heart rate monitoring and spontaneous labor are included.

 

REPORTING

Labor and delivery teamwork leads to fewer cesareans  - this article describes the collaborative practice experience between midwifery, laborists and obstetricians at a hospital in California at the Society for Maternal-Fetal Medicine 2015 Annual Pregnancy Meeting.  This model was able to demonstrate a decline in the rate of cesarean delivery for nulliparous women and an increase in the rate of vaginal birth after cesarean delivery.

Consequences of a primary elective cesarean delivery across the reproductive life  - this article measured maternal morbidity associated with elective primary cesarean delivery versus a trial of labor.  Measured complications of delivery included transfusion, operative injury, deep venous thrombosis, hysterectomy and death. 

PQCNC will bring our regional labor support classes to every perinatal region in the state in 2019. These are interactive trainings, including case scenarios and hands on practice stations to support a vaginal birth. All sessions will begin at 10:00 AM and end at 3:00 PM. Lunch will be provided and there is no charge for participating hospitals.

AUGUST 23rd-REGION II
Forsyth Medical Center 3333 Silas Creek airway Winston-Salem, NC 27103 Charter Hall in the NHFMC Conference Center Parking is free. Park in parking deck Register here 

SEPTEMBER 16- REGION IV
UNC Rex Hospital Rex Heart & Vascular Building 2800 Lake Boone Trail, Raleigh NC. Auditoriums A&B located on the first floor of the Heart & Vascular building Parking is free and participants can park in H&V parking garage.  Register here.

OCTOBER 9- REGION V
SEAHEC 2511 Delaney Avenue Wilmington, NC 28403 Pelican Room Parking is free in a designated lot at 2514 Delaney Avenue, diagonally across from the SEAHEC building. Attendees are to park in this space then access the building through the front doors facing Delaney. Register here.

OCTOBER 17- REGION I 
MAHEC Graduate Medical Education, 121 Hendersonville Road, Asheville, NC 28803  Register here.

 

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Ready to get started and submit your team roster? Click here

PQCNC is proud to announce that registration is now open for the statewide Newborn Hypoglycemia Prevention and Care (NHPC) initiative. 

The NHPC Expert Team will create a concise action plan which will guide hospital NHPC teams in this work as well as measures which will guide teams and the collaborative in this work.

The NHPC collaborative will be facilitated by the PQCNC core team working with your hospital teams and, as with all PQCNC initiatives, will include informative webinars and quarterly face to face learning sessions as well as weekly email updates to keep all apprised of new reports on the topic, opportunities to excel developed by teams, and critical developments in the collaborative.

The PQCNC NHPC initiative offers your facility a unique, structured opportunity to address the challenges of hypoglycemia. This project will be approved for Maintenance of Certification for your physician providers. Our face to face learning sessions will offer CEU and CME credit. 

This all is at NO cost to your hospital.

Want to join us on this incredible journey? - use the links above.

Need more information? - click here  

Questions? - click here 

Tuesday, July 17th at 1200 - register here

Approve data collection and discuss pre-work

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