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INTRAPARTUM SILDENAFIL CITRATE REDUCES OPERATIVE INTERVENTION FOR FETAL COMPROMISE AT TERM – RESULTS OF A PLACEBO CONTROLLED DOUBLE BLIND RCT [RIDSTRESS RCT (ACTRN12615000319572)]

Email: kerewyn.hay@health.wa.gov.au Background: Tertiary centre labour and birthing units are characterised by rapid turnover of both staff and complex patients. This may result in a challenging environment for staff whereby they may not be adequately familiar with either patients or members of the team. The link between ineffective handover and poor patient outcomes has been demonstrated. A reduction in rates of adverse events has been seen with implementation of systematic handover tools, providing oncoming teams with information required to establish team and situational awareness. The need for a structured handover tool in our tertiary centre was identified. Methods: The SAFE handover model was introduced to a tertiary labour ward in December 2017, consisting of Staff introductions; patients Awaiting (theatre, induction, epidural or review); Future (patients at risk of deterioration); and Expects (patient transfers). Pre-implementation and 12-month postimplementation audits were performed. Results: Preliminary results have shown significant improvement in staff awareness following implementation. An increase in all areas; correct staff identification increased from 36% to 95%, awareness of patients awaiting care 47.5% to 92%, identification of future patients at risk 64.5% to 95% and awareness of patient expects 71% to 90%. Conclusions: SAFE had a positive impact on the handover practices on our tertiary labour ward, with significant improvement in situational and team awareness demonstrated. Future assessment of patient outcomes is planned.