Improving Interprofessional Consistency in Electronic Fetal Heart Rate Interpretation.

Area of Science:

• Obstetrics and Gynecology
• Medical Education
• Patient Safety

Background:

• Accurate interpretation of electronic fetal monitoring (EFM) tracings is crucial for intrapartum fetal assessment.
• Discrepancies in documentation between obstetric care providers and nurses can impact patient care and safety.
• Standardized training may improve interdisciplinary communication and adherence to best practices.

Purpose of the Study:

• To evaluate the impact of a mandatory online electronic fetal monitoring (EFM) training course on documentation agreement.
• To assess improvements in the consistency of EFM interpretation documentation between obstetric providers and nurses.
• To determine if the training enhanced the accuracy of documenting fetal heart rate tracing characteristics.

Main Methods:

• Retrospective chart review of 701 patient records before and after mandatory online EFM training.
• Analysis of documentation agreement between obstetric providers and nurses at admission and prior to delivery.
• Evaluation of documentation for variability, accelerations, and decelerations in EFM tracings.

Main Results:

• Significant improvement in documentation agreement for variability (91.1% to 98.3%) and accelerations (75.2% to 87.7%) at admission.
• Significant improvement in documentation agreement for variability (82.1% to 90.6%) and accelerations (56.7% to 68.6%) prior to delivery.
• Non-significant increases in agreement for deceleration interpretation at admission and prior to delivery.

Conclusions:

• A mandatory online electronic fetal monitoring (EFM) training program effectively enhanced multidisciplinary documentation consistency.
• The training led to significant improvements in the agreement of documenting EFM components like variability and accelerations.
• Online EFM education is a valuable tool for improving the quality and standardization of fetal monitoring interpretation in clinical practice.