Impact of service‐wide initiatives to support healthy pregnancy weight gain on weight‐related documentation

Abstract

Background: Excess gestational weight gain is associated with adverse pregnancy outcomes. Addressing barriers to the provision of best practice care that supports healthy pregnancy weight gain could assist staff in clinical care; however, little is known about changes to staff practices after ameliorating barriers. Aims:To evaluate if service initiatives to promote healthy pregnancy weight gain improve weight-related documentation by antenatal staff throughout pregnancy care. Materials and Methods: Service initiatives including staff training, familiarisation with a pregnancy weight gain chart and placement of scales in clinic rooms were introduced. Pregnancy health records were audited for deliveries pre-(2014) and post-implementation (2017) to obtain weight-related measures. Measures assessed included the documentation of pre-pregnancy weight, height, pre-pregnancy body mass index (BMI), referral to dietetic services (if overweight) and the accuracy of pre-pregnancy BMI calculation. The proportion of visits with weight recorded during pregnancy was also audited.Results: A total of 1003 and 1050 records were included from the pre-and post-intervention groups respectively. Significant improvements over time were observed in the documentation of pre-pregnancy weight (P < 0.001), BMI (P < 0.001), accuracy of BMI calculation (P < 0.001) and for obese women proportion of visits with weight recorded (P = 0.02). There was a non-significant increase in the documentation of dietetic referral for overweight women (1.1% vs 2.2%, P = 0.27) and proportion of visits with weight recorded for women across all pre-pregnancy BMI groups (49% vs 51%, P = 0.07). Conclusions:Addressing barriers to supporting healthy pregnancy weight gain through service-wide initiatives may improve weight-related documentation by antenatal staff. K E Y W O R D Sdocumentation, implementation, obesity, pregnancy, weight gain

Healthcare Professional Training Regarding Gestational Weight Gain: Recommendations and Future Directions

“…Together, this led to better documentation regarding women’s weight [ 41 ] and more women met the IOM guidelines for gestational weight gain [ 71 ]. These findings are in line with other research where changes to the practice environment has improved documentation of weight [ 72 ••] and where changes within electronic medical records show most potential [ 73 ••].…”

Incidence and predictors of surgical site infection in women who are obese and give birth by elective caesarean section: A secondary analysis

“…21,22 Counselling childbearing women who are obese regarding the importance of even modest weight loss may improve their outcomes post CS. 23 This and careful monitoring of gestational weight gain 24 are two strategies that have beneficial effects. It is encouraging to note that a recent Australian study showed women felt informed about the risks and benefits of CS and were satisfied with the decisionmaking process.…”

A prospective observational evaluation of an online health care professional training program to promote healthy pregnancy weight gain

“…7 Face-to-face education for health professionals has been demonstrated to improve knowledge and confidence 20 and improve weight-management practices. [20][21][22] However, access to such training is limited, requires dedicated time and resources and is expensive to scale up, especially in a geographically disperse state such as Queensland. Online training has the potential to be flexible and selfpaced, completed from any location (including rural and remote), undertaken at a time or times convenient to the user, as well as providing a cost-effective and scalable delivery method for the training organisation.…”

“…Face‐to‐face education for health professionals has been demonstrated to improve knowledge and confidence 20 and improve weight‐management practices 20–22 . However, access to such training is limited, requires dedicated time and resources and is expensive to scale up, especially in a geographically disperse state such as Queensland.…”