Anna Laberge Hospital Center | The lack of staff in the birthing pavilion has affected the care

Staff shortages at the maternity ward at the Anna Laberge Hospital Center in Châteauguay last winter forced the arrival of several inexperienced nurses. The supervision of these new professionals “was not sufficient to ensure safe care and services for users and newborns,” concludes a new report from the Quebec Ombudsman, which finds, among other things, an increase in epidural anesthesia.

Posted at 5:39pm

Ariane Lacoursiere

Ariane Lacoursiere
The press

The Quebec Ombudsman conducted an investigation between April 4 ande and the 5e Pandemic wave last winter in the maternity pavilion of the Anna Laberge Hospital. This investigation was triggered after “worrying reports” pointing to a “lack of staff training” that would “compromise the quality of services,” we read in the report.

The document, dated April 26, 2022 but released on Tuesday, explains that there was a shortage of qualified staff at the Anna Laberge Hospital’s maternity pavilion. The pandemic had forced staff cuts, particularly in consulting positions. There were retirements and sick leave. The newly hired staff lacked training, which led to various problematic situations.

Not the right oxygen mask

For example, the report explains that the 20 rooms in the birth pavilion were not always well prepared. In some cases, there was a lack of equipment, such as tubes to suck out the baby’s secretions after birth. When a slightly premature newborn was born, “we couldn’t find an oxygen mask in the room that matched his size.” “Since he required CPR care, on-site staff had to find a smaller mask,” writes the Protector, adding that “this situation is worrying as it inevitably resulted in a delay in the care of this newborn suffering from respiratory distress.”

The work organization in the birth pavilion meant that two nurses could look after one woman giving birth and 5 to 6 postpartum patients. This approach “does not ensure continuous monitoring of the mother during labour,” it says.

The Protector points out that of the 40 medical records it analyzed, 85% of women who gave birth without a cesarean section received an epidural. “The facility confirmed to the Quebec Ombudsman an increase in the number of epidurals being used in the last year and mentioned the need to train new staff more in the assessment and management of pain during childbirth,” it reads.

Lack of tracking

The Quebec Ombudsman found that certain key items were not followed up after the birth. For example, “a bottle-fed newborn failed to drink enough more than once in a 24-hour period because caregivers neglected to follow-up and educate parents.”

In one of the files analyzed, a baby who had to have his blood sugar checked every three hours was checked first after ten o’clock and then at seven o’clock. “The medical records say the newborn didn’t have his last blood glucose test because they rang the bell and didn’t get an answer. The staff note explains this delay as an increase in work. However, it is imperative to answer family call bells to verify the urgency of the request,” it said.

The lack of training of the staff in the birthing center also meant that some blood samples taken from the heels of newborns were performed incorrectly and had to be repeated. However, this blood test is described as “traumatic and painful for newborns”. […]. It is therefore important not to repeat it unnecessarily,” notes the Québec Ombudsman.

The latter points out that during the pandemic, the new nurses had learned the technique of taking blood from the foot via conference call. “The staff lacked practical training,” it says.

In his conclusions, the Québec Ombudsman emphasizes the hospital’s full cooperation in the proceedings. Changes have already been made. For example, a plastic foot is now used to train nurses to draw blood. The Quebec Ombudsman nevertheless made 15 recommendations to the facility.

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