This Week in Maternity - Patient safety curriculum, coroner investigative power and breastfeeding peer support
UK Government consultation – Giving coroners power to investigate still births
The UK government has launched a consultation on proposals to give coroners power to investigate all full term still births.
Currently coroners are only able to investigate deaths of babies who have shown signs of life after they were born. The proposal would enable coroners to provide parents with information on the cause of death as well as providing recommendations to avoid further deaths. It is stated that under the proposed system:
You can provide your views on the proposal by completing an online survey available here.
Patient Safety Curriculum
The Patient Safety Movement foundation has developed patient safety curriculum and education resources for healthcare professionals. It is aimed at developing knowledge, skills and behaviors to support improvement of patient safety and reduction of errors.
The resources can be used by those providing education on patient safety to help facilitate teaching. It provides information on how to get started with using the resource along with educational materials.
The curriculum covers 8 topics; error science, system science, human factors, technology, teamwork and communication, leadership and leading change, culture of safety and patient oriented safe care.
For each topic learning objectives are provided along with examples of demonstrating how they are met. There are videos, clinical cases and local experience examples provided along with further clinical resources and suggested reading.
The curriculum is available here.
Breastfeeding support via phone – A randomized controlled trial
A randomized trial has been published looking into the impact proactive telephone-based peer support has on breastfeeding.
The randomized trial conducted across 3 Australian hospitals involved more than 1000 women. The women were randomized to 2 groups – 1 with normal care and the other with normal care plus proactive phone-based support from a trained peer volunteer for up to 6 months post-partum. Only first-time mothers were included in the study.
The study measured the number of babies receiving any breast milk at six months finding that 75% of infants in the peer support group were receiving breast milk compared to 69% with only the usual support. Women in the peer support group had a 23% lower risk of stopping breastmilk feeding.
The study concludes:
‘Providing first time mothers with telephone-based support from a peer with at least six months personal breastfeeding experience is an effective intervention for increasing breastfeeding maintenance in settings with high breastfeeding initiation.’
The study is available here.
Dr Lesley Roberts, Consultant Obstetrician & Gynecologist shares her thoughts on cesarean section and maternal requests.
'Since the change in the NICE guideline we have seen increasing numbers of ladies requesting and even demanding elective LSCS.
Some trusts have decided to deny such requests.
We are in Surrey and recently I have been approached from ladies in other counties many miles from us whose requests have been denied.
We need to have a much better debate around the whole issue of choice in childbirth. We have something like a postcode lottery in relation to what is and is not available to mothers and their partners.
The litigation costs are very high when things do not go well, and many women (and men) suffer the psychological consequences of a birth that did end up being as they had hoped.
I suspect if all ladies were given the option many more would request a caesaerean section.
I am not in the caesarean for all camp as I personally chose to aim for a vaginal birth and was lucky enough to be able to experience the joy of homebirth as well as the unexpected need for an emergency LSCS on another occasion.
What I advocate is that there should be a choice and that choice is a fully informed one.
Lets get the debate going.'
Webinar: Implementing Best Practice PPH Bundle
The institute for perinatal quality improvement has a free webinar series to provide education and support on important perinatal quality improvement topics.
The latest webinar will be on ‘Implementing best practice PPH bundle’ covering policies, practices and procedures, reviewing key parts of the PPH bundle and discussing how it can be implemented.
The webinar series library also contains webinars on other important topics including baby friendly guidelines, care of African American and black mothers and utilizing telehealth.
To sign up to the webinar and access previous recordings click here.
Why Do Hundreds of US Women Die Annually in Childbirth?
800 women in the US die each year during pregnancy or within 42 days after delivery highlights a report from JAMA network. The report outlines the lack of standardization in reporting across states and the incomplete data on causes of death.
Review committees across states are analyzing patient records to identify what went wrong however some committees and unfunded and under resourced. Suitable analysis of the data and relevant action can lead to significant reduction in maternal deaths as demonstrated by Hospital Corporation of America.
It is estimated that more than 60% of pregnancy related deaths can be prevented with major causes including:
Work is being done to try and tackle some of these causes through action including:
The full articles available here provides more details on the current situation.
Maternal deaths and injuries – USA Today investigation