2023 14th Annual NUBE Conference

Background: Management of behavioral health emergencies such as acute agitation in pregnant patients requires knowledge of general agitation management as well as special considerations for this unique population [1]. The growing shortage of psychiatrists places a significant burden on other specialties, who may have to manage complex psychiatric conditions or behavioral health emergencies without the support of in-house psychiatry[2]. Data from a cross-sectional study of Obstetrics and Gynecology (OB-GYN) program directors in the US indicates an overwhelming shortage of psychiatric education throughout OB-GYN residency training attributed primarily to a lack of integration between OB-GYN and Psychiatry[2]. This quality improvement project aims to improve the knowledge and skills of OB-GYN residents in managing agitation in pregnant patients, both in the inpatient and emergency room setting. Method: We have distributed a baseline survey of all OB-GYN residents to assess their comfort level. The psychiatry residents and faculty involved will design and deliver the educational component. We have provided the educational component with case based examples to all OB-GYN trainees, demonstrating basic verbal de-escalation techniques, which are targeted to the pregnant population. We have distributed a post-survey of all OB-GYN residents to assess their comfort level after this educational exercise.This type of simulation quality improvement project has been performed in psychiatry at our hospital, as well as in other departments/institutions, and it has been shown to improve de-escalation skills.Results: Collaborative education with psychiatry for OB-GYN trainees is expected to improve the confidence of trainees in managing agitation in pregnant patients and thereby improve patient safety. We are currently pending survey results. Conclusion: Collaborative education with psychiatry for OB-GYN trainees is expected to improve the confidence of trainees in managing acute agitation in pregnant patients and thereby improve patient safety in both the inpatient and emergency room setting.

Learning Objectives:

1. To assess the OB-GYN trainees’ comfort level in managing agitation in pregnant patients before and after targeted education from the psychiatry department for the purpose of developing integrated training in this crucial skill.
2. To provide educational information to OB-GYN trainees’ regarding basic verbal de-escalation techniques that can be used in the pregnant population.
3. To provide case based examples to facilitate discussion surrounding the utilization of verbal de-escalation techniques that can be used in the pregnant population.