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Published on: January 12, 2018
Provider attitudes toward clinical protocols in obstetrics
Sayeedha G Uddin1, Jill A Marsteller, J Bryan Sexton
1National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA. suddin@cdc.gov
Summary
Obstetrical providers generally accept clinical protocols, but attitudes toward the Johns Hopkins Oxytocin Protocol (JHOP) vary. While most agree on general protocol benefits, fewer attending physicians/certified nurse midwives view the JHOP as crucial for patient safety compared to registered nurses.
Area of Science:
- Obstetrics and Gynecology
- Clinical Protocol Development
- Patient Safety Research
Background:
- Clinical protocols are essential for standardizing care in labor and delivery.
- The Johns Hopkins Oxytocin Protocol (JHOP) is an institutional guideline for oxytocin use.
- Understanding provider attitudes towards specific protocols is crucial for effective implementation.
Purpose of the Study:
- To compare obstetrical providers' attitudes towards general clinical protocols and the specific JHOP.
- To assess agreement among registered nurses (RNs), physicians in training (PITs), attending physicians (APs), and certified nurse midwives (CNMs) regarding protocol benefits and patient safety.
- To identify any significant differences in attitudes across provider groups.
Main Methods:
- Distribution of the Johns Hopkins Oxytocin Protocol (JHOP) Survey to labor and delivery clinical staff.
- Assessment of agreement with four attitudinal statements concerning clinical protocol and JHOP use.
- Statistical comparison of agreement odds among different provider groups (RNs, PITs, APs, CNMs).
Main Results:
- No significant differences were found in agreement with general clinical protocols across provider groups.
- Agreement regarding JHOP use leading to better practice did not differ significantly among provider groups.
- Attending physicians/certified nurse midwives showed lower agreement on the JHOP's importance for patient safety compared to registered nurses.
Conclusions:
- Obstetrical providers generally have positive attitudes toward the use of clinical protocols.
- While overall acceptance of clinical protocols is high, specific institutional protocols like the JHOP may elicit differing provider opinions.
- Further investigation into the reasons behind attitude variations towards specific protocols is warranted for successful implementation and improved patient safety.
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