ICU Care of the Obstetric Patient: Using Medical Record Data to Inform Next Steps in Nursing Education

Background: Intensive Care Unit (ICU) admissions have increased among obstetric and postpartum (OB) patients. ICU Nurses have expressed feeling unprepared to treat OB patients without improved guidance. This demonstrates need for expanded education on nursing care for OB ICU patients. Objective: The purpose of this review is to determine foci for nursing education to promote effective and confident care of OB ICU patients. The aims are: 1) describe admission and patient factors for OB ICU patients, 2) synthesize data on care and outcomes of the population, 3) recommend topics for nursing education on ICU care of OB patients. Methods: Search was conducted in PubMed and CINAHL, screening and selection in Covidence, and quality assessment through the JBI manual and CASP. Outcomes included patient characteristics, diagnoses at admission, ICU interventions, and admission outcomes. Articles were included if published between January 2018 and May 17, 2023, English language, and analyzed medical records or surveillance data on OB ICU admissions. Results: Thirteen studies were included. Studies found that patients were primarily admitted to ICU during the third trimester or postpartum. Key admission conditions include hemorrhage, hypertension, and sepsis. Most common interventions included ventilation, intubation, invasive monitoring, diuretics, and surgery. Maternal mortality was attributed to sepsis, respiratory arrest, hemorrhage, heart failure/arrest, and renal failure. Conclusion: Future ICU nursing education should focus on OB nursing considerations for treatment of hemorrhage, hypertensive disorders, and sepsis, along with ventilation, intubation, invasive monitoring, diuretics, and surgery.