writing policies and protocols: NARM

[cathicog]

When one is writing out one's policies and protocols for NARM, done one have to use a bibliography, citations, and other documentation of sources for one's policies? Has anyone got an example to share?TIA

[nashvillemidwife]

Cathi, I just use the TMA Practice Guidelines. They will be posted on the website soon.

[riomidwife]

no you don't need to supply sources, although if you're significantly deviating from your community standard of care it would help to have sources to support your particular protocol. in any case, your protocols should reflect what you actually do, so if you are using someone elses be sure they reflect how you actually practice.

[mwherbs]

if you live in a legal state start with the state laws/regulations. write as open as you can get as far as protocols- for the most part you don't want to write something you will be locked into doing a certain way or something that must be done everytime x comes up. Notice the use of "consider" - in other areas you may want to say hourly or midwife's discretion,client's desire , may include,may be performed as indicated, the following measures will be utilized if indicated but not necessarily performed in the order given (you don't have to have the research but it doesn't hurt to have some documentation available in a file cabinet somewhere)

an example --
Management of Antepartal Problems
1) Anemia
a. Hgb<12 or <35, consider:
-- Prenatal vitamins and or/Fe supplements
-- Dietary counseling
b. If Hgb<10,hct<30, and/or MCV<80 consider:
--Reticulocyte count
--Hgb electrophoresis with quant A2 and F
--Serum Fe and TIBC, or ferritin
c. If MVC>80 consider:
-- Serum folate
-- B12, strict vegetarian(vegan)
Recommend:
- Folacin 500mcg-1mg PO
-Dietary counseling

2) Bleeding in Pregnancy
a.First Trimester

[cathicog]

Oh, OK, thanks all! I think i am making this harder on myself than it needs to be! I was writing a book! LOLOL! Nashvillemw, I will use the TMA guidelines, excellent idea!

[riomidwife]

yeah i think it's better to err on the side of brevity, describing only what you will due in practice. if you write a book for each clinical issue, odds are you are not going to follow that protocol in each instance the issue comes up.