The OR and birth department teams at the Hôpital de La Malbaie du CIUSSS de la Capitale-Nationale worked in close collaboration to create a new Caesarean section (C-section) protocol. The project objective was to reduce wait times between the moment the C-section is requested and the birth of the baby, mainly for emergency C-sections that are life-threatening to the mother or fetus. To accomplish this, we began conducting systematic interdisciplinary debriefs after each C-section and conducted simulation exercises to identify problems and faulty equipment. File audits were also conducted to determine when wait times were too long. After these audits, cross-departmental consultations identified communication issues and duplicate procedures. We have developed a new C-section protocol that includes a clear procedure, proper terminology, timelines to adhere to, and a description of each staff member’s role and tasks. In addition, training activities, simulations and clinical tools were introduced. Our project led to a decrease in wait times between the time the C-section is requested and the birth of the baby by almost 17 minutes in cases of extremely emergent C-sections, which has a positive impact on maternal and fetal outcomes, safety, and quality of patient care.

Project submitted by Stéphanie Bergeron, Obstetrics Nursing Consultant

Other contributors: Dr. Jasmine St-Martin, Obstetrics GP, Dr. Karina Rollin, Surgeon, Dr. Hala Hanna, Surgeon, Dr. Darius Treigys, Anesthesiologist, Marie-Josée Demers, Specialized Nursing Advisor, Cindy Tremblay, Assistant Head OR Nurse, Karine Houde, Respiratory Therapist, and birth department and OR nurses