The introduction of electronic fetal monitoring (EFM) in the late 1960's has had a huge impact on perinatal care and the practice of nursing. With attention on the effects of perinatal morbidity and mortality and the role in healthcare costs and malpracticee litigation, EFM is used in the majority of labor and delivery units in the United States. The National Institute for Child Health and Development (NICHD) introduced standardized FHR pattern definitions and Joint Commission on Accreditation of Healthcare Organizations (JCAHO) recommended use of standard language for communication and documentation of FHR patterns. In 2005, the Association of Women's Health, Obstetric, and Neonatal Nurses (AWHONN) and the American College of Obstetricians and Gynecologists (ACOG) supported the adoption of the definitions for FHR patterns.
Clincal reliance on EFM is high and is used in the clinical setting to determine adequacy of fetal oxygenation and well-being during labor. Adoption of a common language for FHR pattern definitions and documentation is routinely used by all providers which enhances interdisciplinary communication and maternal-fetal safety.
Over the next 4 weeks, there will be postings that will define FHR patterns, discuss physiologic basis for FHR monitoring, interpretation of FHR, and nursing management of FHR patterns.
Simpson, K. (2009). Fetal assessment during labor. In Simpson, K. & Creehan, P. (2008). Perinatal Nursing, 3rd ed. Philadelphia, Pa: Lippincott, Williams, and Wilkens.
Debra,
ReplyDeleteI love the background. It immediately made me feel restful.I remember using the fetalscopes when I started. They were heavy and cumbersome. I do find that there is a heavy reliance on the EFM where some nurses will not let the patient off of them at all. What was your stand on the patient being off the monitor for short periods of time?
Debra, Great job with this blog. Your blog was very informative. I can tell that you have a passion for this. I am looking forward to more blogs.
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