Methodist Medical Center of Illinois
Page # 1 of 2
Section: 2
Approved by:
NEW: 12/3/12
© MATERNAL/CHILD
Policy #: 37
Date:
NEW
Policy/Revision Submitted by: Lindsay Vlaminck, RNC
JCAHO Standard:
SUBJECT: Scheduling of Procedures on Labor and Delivery
POLICY:
Patients will be scheduled for induction of labor or cesarean section based upon best practice guidelines.
Patients with an acceptable medical reason will be prioritized and accommodated first.
PURPOSE: To identify appropriate patients for elective delivery and provide clear expectations for scheduling
of procedures in the labor and delivery department to ensure compliance with best practice guidelines.
SCOPE:
Labor and Delivery Department
GENERAL INFORMATION:
For the purpose of this policy, gestational age will be confirmed in one of three ways:
1.
2.
3.
Ultrasound before 20 weeks gestation
Confirmed heart tones for greater than 30 weeks of the pregnancy
At least 36 weeks have lapsed since a positive serum pregnancy test
In the event the L&D department needs to prioritize admissions due to unit dynamics, elective inductions
will be placed on hold to accommodate spontaneous labor patients and medical inductions. The attending
provider will be notified of the need to reschedule the patient having an elective induction, as well as
notifying the patient. Patient safety is the ultimate determination of how many patients can be scheduled
or accommodated on any given day. Due to potential risks of pitocin, patients scheduled for pitocin induction
will be educated and informed consent will be obtained prior to start of induction.
The following is required for elective induction of labor:
1.
2.
3.
Patient must be at least 39 weeks gestation.
Patient must have a documented bishop score ≥8.
All paperwork must be submitted from the office 24 hours prior to scheduled induction:
a. A completed indication for induction form, including GBS status
b. Hepatitis B results (actual lab value)
c. Recent copy of prenatal records
d. Pitocin consent form (if applicable)
All required documentation must be submitted before final approval by the OB Clinical Charge Nurse. The OB
Clinical Charge Nurse is the “hard stop” to prevent scheduling patients that do not meet the requirements.
Acceptable reasons for medical indications for induction are outlined on the Indication for Induction form. The
benefit of an early delivery needs to outweigh the risks to both mom and baby. Approved medical indications
have been identified through The Joint Commission and ACOG and apply to both inductions and cesarean
sections.
In the event a patient does not meet the requirements outlined in this policy, the Clinical Charge Nurse will
not schedule the procedure. If the provider is insistent, the Chain of Command will be followed.
Scheduling of Procedures on Labor and Delivery S2P37
PROCEDURE:
1. Physician office staff will contact the OB Clinical Charge Nurse (OB CCN) to identify the day and time
requested for a scheduled procedure (inductions, c-sections)
2. For an induction of labor, the clinical charge nurse will complete the admit order set for induction
(7610.002)
3. For scheduled cesarean sections, the clinical charge nurse will contact surgery scheduling to ensure
patient is on the surgery schedule. Patient will be scheduled for pre-bed testing within 3 days of
delivery.
4. All procedures will be recorded in the labor and delivery schedule book.
5. A completed indication for induction form, GBS and Hepatitis B results, pitocin consent form (if
applicable) and a recent copy of prenatal records need to be faxed to L&D.
6. The bishop score needs to be ≥ 8 for a scheduled elective induction.
7. The OB CCN will review the documentation for compliance with requirements for an elective
induction.
Approved by OB Interdisciplinary Committee on December 10, 2012
References:
Specifications Manual for Joint Commission National Quality Measures (v2013A)
ACOG Practice Bulletin Number 107, August 2009.
Scheduling of Procedures on Labor and Delivery S2P37