Severe maternal morbidity has been steadily increasing in the United States, but a multidisciplinary team at the Brigham is working to change that, one patient at a time. The team, which includes Karen Manganaro, MSN, RN, and Valerie Sweeney, MSN, RNC-OB, of the Center for Labor and Birth, recently published an article in the American Journal of Obstetrics and Gynecology detailing their study findings.
The team discovered that using a nurse-driven screening tool — the obstetric co-morbidity index — can identify women at risk for severe maternal morbidity at the time of delivery. They also found that routine use of this tool has the potential to identify at-risk women who need increased monitoring and targeted care to prevent adverse maternal outcomes.
The tool, which was developed by Brian Bateman, MD, MSc, of the Department of Anesthesiology, Perioperative and Pain Medicine, assigns points for risk factors and then adds the points to generate a score for each patient. During rounds, team members review patients’ scores, which helps them discuss risk factors in a standardized way.
“If the number is low, we know that the patient’s history likely isn’t increasing risk of severe maternal morbidity,” said Manganaro. “But if the number is high, it immediately prompts a discussion of what is happening and how to develop the appropriate care plan.”
The obstetric co-morbidity index will go live in Epic throughout the Partners HealthCare system next month.
“This study is one of the most significant accomplishments in my nursing practice,” said Sweeney. “It feels incredible to be able to make this kind of positive impact not only for our obstetric patients, but for others in the Partners system and beyond as we present and share our findings.”
The study was led by Sarah Rae Easter, MD, of the Division of Maternal-Fetal Medicine, and Julian Robinson, MD, chief of Obstetrics, in addition to Bateman, Manganaro and Sweeney.