OB HUB: Remote Electronic Fetal Monitoring Surveillance

Area of Science:

• Obstetrics and Gynecology
• Neonatal Care
• Health Informatics

Background:

• Electronic fetal monitoring is crucial for fetal well-being.
• Timely interpretation and response to fetal heart rate tracings are essential for preventing adverse neonatal outcomes.
• Current systems may have limitations in vigilance and response times.

Purpose of the Study:

• To implement a remote fetal surveillance unit named OB HUB.
• To enhance vigilance and response times for electronic fetal monitor tracings.
• To improve neonatal outcomes and patient safety through advanced monitoring.

Main Methods:

• A pilot project implemented the OB HUB, a centralized remote fetal surveillance unit.
• Utilized artificial intelligence software and dedicated nurse experts for fetal monitoring interpretation.
• Established notification parameters for consistent communication between remote and bedside nurses.
• Analyzed neonatal outcomes including body cooling, cord pH, Apgar scores, and cesarean births.

Main Results:

• Analyzed 4,989 births (2,407 pre-implementation, 2,582 during trial).
• No significant difference in neonatal cooling events (0.25% pre vs. 0.08% during trial; p = .10).
• No statistically significant differences observed in other neonatal outcomes between groups.
• Perceived safety levels remained similar, though 78.8% of responding nurses felt the OB HUB improved safety.

Conclusions:

• The study faced challenges demonstrating statistically significant improvements in neonatal outcomes due to a low incidence of adverse events.
• A larger sample size is recommended to establish the clinical utility of the OB HUB.
• The OB HUB system received favorable perceptions from labor and delivery nurses regarding safety.