The intensive care experience of maternity patients

Abstracts cant differences in the type of events. Respiratory problems and infections were the most frequent reasons for AEs in ‘2007’ compared to fluid-related issues in ‘2006’. We believe the discharge plan contributed to a change in the nature and preventability of events, but not the frequency. doi:10.1016/j.aucc.2007.12.018 Expanding the scope of nursing practice in caring for patients supported on extracorporeal membrane oxygenation (ECMO) Serena O’Brien* , Vincent Pellegrino The Alfred, Melbourne, Australia Extracorporeal membrane oxygenation (ECMO) therapy was implemented at The Alfred ICU in 1990 with approximately 20 patients requiring ECMO annually. In 2003, a collaborative educational program was developed whereby perfusionists no longer remained on site 24 h/day and intensive care nurses assumed greater responsibility in managing these patients and the ECMO device. The education program involved a 2-day course followed by a period of clinical exposure preceding a single bedside competency assessment. Since its inception, 109 Alfred nursing staff have participated in the ECMO course and forty nurses (37%) remain employed within the unit. A local survey was conducted to determine if ECMO trained nurses felt prepared to competently care for patients supported on ECMO therapy and explored their attitudes to this expanded scope of practice. Quality assurance approval was obtained and the survey tool using the Likert scale was piloted. All current ECMO trained nurses were surveyed (n = 40) and the response rate was 70% (n = 28). The survey results demonstrated that all ECMO trained nurses (n = 28) reported that the educational program prepared them to competently care for patients supported on ECMO therapy. The majority felt competent if required to manage a critical incident and 23 nurses (79%) reported involvement in at least one incident. The majority of nurses surveyed supported this expansion to their scope of practice. The survey results validate the educational program and expanded scope of practice for intensive care nurses and has contributed to the growth of ECMO services at The Alfred ICU. doi:10.1016/j.aucc.2007.12.019

59 The intensive care experience of maternity patients Claire Minton* , Cheryl Benn Massey University, New Zealand It is estimated that approximately 2% of maternity patients in developed countries will require an admission to the intensive care unit (ICU) as a result of complications related to pregnancy, childbirth and the postpartum period. Whilst there is a wealth of international literature describing the experience of ICU patients in general there is no literature that addresses the experience for maternity patients. For this group the recognized psychological consequences of ICU admission are further exacerbated by the need to manage bonding, breastfeeding and adjustment to parenting in the post ICU admission period. The aims of this study were to investigate the experience of women who have had an intra or postpartum ICU admission. In this exploratory qualitative study 12 women had in-depth interviews about their experience of being in intensive care as a result of a complication from pregnancy, childbirth or postpartum. The main themes identified were: (1) ICU was a haze with a consuming feeling of fear. (2) Gradual realization of how they were. (3) Being left to cope by health professionals. (4) Multifaceted grief process. (5) Seeking answers. (6) A long slow recovery. (7) Trying to move on. In this paper these themes are explored with recommendations made in relation to significant areas for improvement in care and monitoring for the future for this group of woman across the intensive care and maternity services. These findings are important for the future of service delivery as the literature predicts increasing likelihood of ICU admission for the maternity patient. doi:10.1016/j.aucc.2007.12.020 Breastfeeding after intensive care Cheryl Benn* , Claire Minton Massey University, New Zealand Aim: The findings from a qualitative study undertaken to explore 12 maternity patients’ experience of breastfeeding after being in ICU are presented. Background: Separation of mother and baby may occur because of a mother having had a life-threatening episode during her childbearing