A Patient Safety Bundle for Shoulder Dystocia

BACKGROUND: Shoulder dystocia is an often-unpredictable obstetric emergency that can result in significant neonatal and maternal injury. Appropriate preparation, anticipation, and management can significantly mitigate these injuries. METHODS: We performed a review of the relevant medical literature to develop a patient safety bundle, modeled after the American College of Obstetricians and Gynecologists Alliance for Innovation on Maternal Health bundles. Patient safety bundles are a set of evidence-based guidelines, which can be adapted for local circumstances to assist teams in the management of a medical condition with the intention of improving outcomes. RESULTS: The patient safety bundle we are proposing is organized into five domains: Readiness, Recognition and Prevention, Response, Reporting/Systems Learning, and Respectful, Equitable, and Supportive Care. CONCLUSION: We have developed a patient safety bundle to optimize the management of shoulder dystocia. While bundle components may be adapted to meet resources available in individual settings, standardization within an institution is strongly recommended. The bundle is meant to be a framework for facilities to adopt to foster optimal care of this challenging complication of vaginal delivery.