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Patient labelObstetric Emergency Team Debriefing FormRemember Debriefing is meant to be a learning experience and a way to address both human factors andsystems issues to improve the response for next time There is to be no blaming finger pointing Date and time of event Location of event .
Event Stat C S Seizure Cardiac event Stroke Maternal code Transfer to ICU NICU codePE Shoulder Dyst Amniotic embolism Other .
Who was present Name and role check if present at debriefing .
Identify opportunities forThinking Identify opportunities for improvement systemsIdentify about.
wentthe obstetric emergency was managed well improvement human issue Check if yes factors Check if yes Check if yes Communication Communication Equipment Role clarity leader supporting Role clarity leader supporting Medication.
roles identified and assigned roles identified and assigned Blood product availability Teamwork Teamwork Inadequate support in unit or Situational awareness Situational awareness other areas of hospital Decision making Decision making Delays in transporting the Other Other patient.
Other .
Obstetric Emergency Team DebriefingFor identified issues fill in table belowIssue Actions to be Taken Person ResponsibleEnsure that your patient and family understands what happened and support is provided Turn into the Nurse Clinician mailbox when completed .
Submit a Safety Intelligence Report PSN if appropriate Patient labelObstetric Hemorrhage Team Debriefing FormRemember Debriefing is meant to be a learning experience and a way to address both human factors andsystems issues to improve the response for next time There is to be no blaming finger pointing .
Date and time of event Location of event Criteria met VD 1L blood loss CS 1 5 L blood loss Bakri B Lynch HysterectomyAdministration of Blood Products Other Was patient assigned a hemorrhage risk Low Medium High Not done .
Volume of blood lost Method QBL Visual estimation Both Who was present Name and role check if present at debriefing .
Identify opportunities for.
Thinking Identify opportunities for improvement systemsIdentify aboutwentthe obstetric emergency was managed well improvement human issue Check if yes factors Check if yes Check if yes .
Communication Communication Equipment Role clarity leader supporting Role clarity leader supporting Medicationroles identified and assigned roles identified and assigned Blood product availability Teamwork Teamwork Inadequate support in unit or Situational awareness Situational awareness other areas of hospital .
Decision making Decision making Delays in transporting the Other Other patient Other .
Obstetric Hemorrhage Team DebriefingFor identified issues fill in table belowIssue Actions to be Taken Person Responsible.
Ensure that your patient and family understands what happened and support is provided Turn into Nurse Clinician mailbox when completed Submit a Safety Intelligence Report PSN if appropriate Obstetric Emergency Team Debriefing Form. Remember: Debriefing is meant to be a learning experience and a way to address both human factors and systems issues to improve the response for next time.

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