P.U.R.E. (purposeful, unambiguous, respectful, and effective) Conversations and electronic fetal monitoring: gaining consensus and collaboration.

A revised nomenclature regarding electronic fetal heart rate monitoring was accepted at a National Institute of Child Health and Human Development consensus conference in 2008. At the heart of patient safety are communication strategies that enhance teamwork and collaboration between health care professionals. Communications is a complex 2-way process that involves more than transfer of factual information. P.U.R.E. (purposeful, unambiguous, respectful, and effective) Conversations in Obstetrics is an acronym that helps facilitate this communication process in perinatal care. P.U.R.E. stands for purposeful, unambiguous, respectful, and effective. The P.U.R.E. Conversations approach involves refinement of the mental processes associated with delivering the message, delivery of the message with data, accuracy, and direct requests for action, attention to relationships and behaviors between the communicating parties, and real-time assessment of the effectiveness of the communication. When the new electronic monitoring nomenclature is combined with an effective communication tool, one could expect to see a reduction in communication failures that could lead to adverse perinatal outcomes.