Question of the Week

The nurse manager of the maternal-child unit is evaluating how well the unit met the ACOG (American College of Obstetrics and Gynecology) standard of starting a cesarean section within 30 minutes of the decision for surgery. What is the best way for the nurse manager to assess if the standard is met?

1.	Do a chart review for documentation of time of decision and time surgery began and compare to the national standard.
2.	Interview the nurses involved in the case as to how long it took from decision to surgery.
3.	Assume that all emergency cesarean sections are done within the recommended 30 minutes.
4.	Ask the obstetricians how long it took from the time they ordered the surgery until they made the first cut.

Correct
Documentation needs to reflect the standards of care. If the nurses routinely chart time of the decision and time surgery began, data can be collected to compare the unit's practice with national standards. Asking physicians or nurses after the fact will not give accurate data. One cannot assume that 30 min. is always the time unless it is consistently documented.

Incorrect
Documentation needs to reflect the standards of care. If the nurses routinely chart time of the decision and time surgery began, data can be collected to compare the unit's practice with national standards. Asking physicians or nurses after the fact will not give accurate data. One cannot assume that 30 min. is always the time unless it is consistently documented.

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