[Reducing the Invalid Alarm Rate for Fetal Heartbeat Monitoring in High-Risk Pregnancies in the Delivery Room].

Abstract

Background & problems: Fetal heartbeat (FHB) monitoring is used to monitor the condition of a fetus in the uterus and estimate the expected time of delivery. It is crucial to accurately and comprehensively monitor fetal heart beats in high-risk pregnancies. However, invalid alarms frequently occur in clinical environments, easily promoting alarm fatigue among nurses and causing anxiety and distrust in the laboring women and their families. Health professionals may ignore valid alarms due to alarm fatigue and miss the opportunity to save a fetus' life. A survey in our hospital identified invalid alarm rates for fetal heart beats as high as 65.1%, with causes including a lack of standard operating procedures for FHB monitoring in high-risk pregnancies and incomplete health education.

Purpose: This project was developed to reduce the rate of invalid alarms in FHB monitoring in high-risk pregnancies to less than 42.8%.

Resolutions: According to patient safety references for medical equipment management, our team established FHB monitoring standards and procedures for high-risk pregnancies. We edited FHB monitoring nursing guidance leaflets and multimedia health education videos. Nurses distributed the health education leaflets and explained the purpose and precautions during labor to expectant mothers at hospital admission. We invited nurses to share the dilemmas of caring for high-risk pregnancy experiences with nurses and obstetricians. Obstetricians and nurses proposed joint solutions for monitoring to improve the feasibility of comprehensive FHB monitoring and reduce the rate of invalid alarms.

Results: The invalid alarm rate associated with FHB monitoring in high-risk pregnancies was reduced from 65.1% to 21.3%. In addition, the integrity of FHB monitoring was increased from 41.7% to 100%.

Conclusions: This project effectively reduced the invalid alarm rate for delivery room nurse FHB monitoring in high-risk pregnancies and improved the integrity of this monitoring procedure. Adopting this approach has the potential of reducing anxiety and distrust in women in labor and their families, thereby enhancing the quality of care provided to these women experiencing high-risk pregnancies.