THE PROCESS OF OBSTETRIC TRIAGE - MANAGEMENT BY CERTIFIED NURSE-MIDWIVES

The roles for certified nurse-midwives are growing, changing, and beco ming more varied with the reform of health care systems. Versatility o f clinical knowledge in antepartum, intrapartum, postpartum, and gynec ologic care along with advanced practice skills of assessment, diagnos is, and treatment make nurse-midwives ideal providers to perform triag e for a busy obstetric service. With health care dollars more limited and more scrutinized than ever before, it becomes essential to priorit ize patient needs and match them with the most appropriate resources. The article demonstrates the process of triage provided by certified n urse-midwives in a high-volume university hospital setting. It describ es management guidelines and admission criteria for the birth center, high-risk labor and delivery, and the observation unit. Examples of cl inical evaluations and judgments as well as scenarios are included to illustrate how triage is unique and differs from care provided in othe r settings.