Govindappagari Shravya, Zaghi Sahar, Zannat Ferdous, Reimers Laura, Goffman Dena, Kassel Irene, Bernstein Peter S
Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, New York.
Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York.
Am J Perinatol. 2016 Jul;33(8):808-13. doi: 10.1055/s-0036-1572540. Epub 2016 Feb 23.
Objective To determine if mandatory online training in electronic fetal monitoring (EFM) improved agreement in documentation between obstetric care providers and nurses on labor and delivery. Methods Health care professionals working in obstetrics at our institution were required to complete a course on EFM interpretation. We performed a retrospective chart review of 701 charts including patients delivered before and after the introduction of the course to evaluate agreement among providers in their documentation of their interpretations of the EFM tracings. Results Agreement between provider and nurse documentation at the time of admission improved for variability and accelerations (variability: 91.1 vs. 98.3%, p < 0.001; and accelerations: 75.2 vs. 87.7%, p < 0.001). Similarly, agreement improved at the time of the last note prior to delivery for documentation of variability and accelerations (variability: 82.1 vs. 90.6%, p = 0.001; and accelerations: 56.7 vs. 68.6%, p = 0.0012). Agreement in interpretation of decelerations both at the time of admission and at the time of delivery increased (86.3 vs. 90.6%, p = 0.0787, and 56.7 vs. 61.1%, p = 0.2314, respectively) but was not significant. Conclusion An online EFM course can significantly improve consistency in multidisciplinary documentation of fetal heart rate tracing interpretation.
确定电子胎儿监护（EFM）方面的强制性在线培训是否能提高产科护理人员与护士在分娩记录上的一致性。方法：我们机构从事产科工作的医护人员被要求完成一门EFM解读课程。我们对701份病历进行了回顾性图表审查，这些病历包括该课程引入前后分娩的患者，以评估医护人员在EFM描记解读记录方面的一致性。结果：入院时医护人员与护士记录在变异性和加速方面的一致性有所提高（变异性：91.1%对98.3%，p<0.001；加速：75.2%对87.7%，p<0.001）。同样，在分娩前最后记录时，变异性和加速记录的一致性也有所提高（变异性：82.1%对90.6%，p=0.001；加速：56.7%对68.6%，p=0.0012）。入院时和分娩时减速解读的一致性有所增加（分别为86.3%对90.6%，p=0.0787；56.7%对61.1%，p=0.2314），但不显著。结论：在线EFM课程可显著提高胎儿心率描记解读多学科记录的一致性。
