Triage issues in an out-of-hospital birth center

Effective triage in an out-of-hospital birth center helps low-risk women av oid high-risk care. Background issues include the contributions of evidence -based practice, informed consent, patient education, problem-focused docum entation, after hours access to client data, and the value of intuition. Te lephone triage, immediate referral, birth center management, and follow-up with counseling are outlined for common out-of-hospital triage problems: fi rst trimester bleeding, nausea and vomiting, second and third trimester ble eding, urinary tract symptoms, decreased fetal movement, contractions < 37 weeks, rupture of membranes, contractions greater than or equal to 37 weeks , and "emergency" delivery. (C) 1999 by the American College of Nurse-Midwi ves.