IHealth in the LDR at VGH

Island Health’s third central monitoring system installed to support safe deliveries for moms and babies

A woman in labour tries to catch a few precious minutes of sleep in the hospital room where she will eventually give birth. Just beyond the door to her room in the Labour and Delivery (LDR) unit at Victoria General Hospital (VGH), the care team confers around a large screen to view her baby’s heartbeat and her own vital stats in real-time.

The screen, called a central monitoring board and located at the main nursing station, offers a central location away from the bedside where nursing and medical staff can view the information that can make all the difference in critical care decisions for a parent in labour.

“There’s a lot of people glancing at it and we’re all there with the same goal,” said Dr. Hayley Bos, Maternal-Fetal Medicine Specialist and Medical Director at VGH. “We want a safe delivery for mom and a safe delivery for baby.”

VGH is now one of three labour and delivery units in the region with a central monitoring board, joining Nanaimo Regional General Hospital and Cowichan District Hospital. VGH will be the first to implement new technology called FetaLink, which links the labouring patient’s continuously updated data to their chart in the electronic health record (EHR). FetaLink will be introduced at VGH in February 2024 as part of a facility-wide IHealth activation.

Central Monitoring Board improves care team communication, collaboration

In the meantime, the central monitoring board has improved communication and collaboration among care team members, and has supported high quality care for labouring patients.

“I can continually watch it without having to be at the patient’s bedside, which is much more reassuring for them,” said Dr. Bos, “There is evidence that the more stressed moms get in labour, the more pain they experience with contractions.”

Laura Warmington, RN and Clinical Nurse Lead in the LDR unit at VGH, said the addition of the central monitoring board has offered opportunities for nursing staff to learn from one another as they view fetal heart ‘tracings’ across the centralized screen.

“It just allows for a more collaborative look at some of our tracings,” she said. “Whereas previously, the nurses brought their tracings out for collaborative view, which is part of our practice and culture, now the board supports that to happen a little more seamlessly.”

Dr. Bos also points to the “mini educational opportunities” now available where nurses and physicians can review and discuss central monitoring board data on their patients together.

“I think it makes staff more comfortable actually talking about the uncertainty of the tracing away from the bedside,” she said, “because the reality is that heart rate tracings are good, but they’re not perfect.”

In an environment that can go from relatively quiet to urgently hectic in moments, with more than one parent on the unit either delivering or requiring additional support, the central monitoring board is a welcome addition as it is continuously monitored by the charge nurse stationed there to support labouring patients in all eight rooms.

“It’s a very busy unit,” said Warmington. “Our average number of deliveries is over 3,000 babies a year. We do roughly 10 deliveries in a 24-hour period.”

VGH is the Island’s largest LDR unit offering specialized maternal fetal medicine, where many patients present with challenges that range from high blood pressure or gestational diabetes to other health challenges that can complicate a pregnancy. The unit also sees many parents who are either past their due dates or labouring too early.

Next step: FetaLink to bring new efficiencies and patient benefits 

When FetaLink is introduced at VGH in February, the collaboration and patient benefits made possible with the central monitoring board will expand beyond the hospital’s walls.

Physicians will be able to view fetal heart tracings and a labouring parent’s data remotely with access to any computer onsite, or outside the hospital.

Dr. Bos said she looks forward to accessing important, in-the-moment information on her patients from anywhere – a potential time saver for physicians and a benefit to care teams seeking advice.

“It allows more appropriate triage of the providers’ resources, because they’re stretched so thin,” she said.

While a learning curve lies ahead for all staff in the unit before FetaLink is implemented, Dr. Bos and Warmington anticipate that the benefits for both parents-to-be and care providers are worth it.

“The care provider doesn’t have to come to the hospital and look in the patient’s physical chart,” said Warmington. “And FetaLink will allow care providers in the community to see patients’ tracings much, much sooner.”

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