Discussion: Labor Care Simulation Scenario

Discussion Aleesha Moore is a 22 year-old G1P0 at 40 3/7 weeks gestation. She has had regular prenatal care with your 3 provider midwifery practice beginning at 10 weeks gestation.

Early Labor Scenario

Aleesha Moore is a 22 year-old G1P0 at 40 3/7 weeks gestation. She has had regular prenatal care with your 3 provider midwifery practice beginning at 10 weeks gestation. You’ve seen her and her mother Sheryl several times and have a warm and friendly relationship with both. She has no significant medical history and has had an uncomplicated pregnancy. You meet her at the maternity unit for a labor evaluation. You practice at a level 1 community hospital where midwives practice autonomously and policies support physiologic birth.

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Aleesha’s contractions began last night at 8 pm. She arrives at the hospital at 10 am. The R.N. takes Aleesha’s vital signs, dips her urine for a urinalysis and places her on the electronic fetal monitor. It is now 1030. You review Aleesha’s chart and note the following information: Vital signs are as follows: B.P. 114/66, P 84, R 18, T 98.8. U/A shows: protein-negative, glucose-negative, ketones-1+, deep yellow color. The electronic fetal monitor was on for a 20 minute strip-The baseline is in the 140’s, baseline variability amplitude range 20 bpm, 3 accelerations to high 150’s for 15-20 seconds, no decelerations. Discussion: Labor Care Simulation Scenario

Reflection/Write up

Please discuss and reflect on the following questions for the Simulation Write up:

Provide a detailed description on the group preparation for the simulation. Include when the first contact occurred, when you met and what you did during the meetings.

Discuss one or two “take home points” that you gleaned from doing this simulation.

An important part of Evidence Based Care is translating evidence (information from the scientific literature) to improve outcomes. Discuss this aspect of your simulation. Be specific about the following:

What information from the scientific literature was used and how it was translated?

How did Aleesha respond?

Did you experience or observe any challenges in discussing evidence (scientific literature)?

If no evidence (scientific literature) was shared, why do you think this occurred and what, in retrospect, what should have been done differently (be detailed and specific here).

Some tips for the simulation:

1. Be systematic in your data collection. This means beginning with and completing subjective data collection BEFORE and moving to objective data collection. What you find from the subjective data collection informs what objective data you need to collect.

2. Collect ALL data before moving to diagnoses and plan.

3. Follow the steps of Shared Decision Making as outlined in the powerpoint presentation in module 1. Discussion: Labor Care Simulation Scenario