Recognising and responding to acutely deteriorating women in New Zealand maternity wards: A literature and environmental scan

Dann, Leona; Hill, Jennifer

doi:10.12784/nzcomjnl54.2018.7.51-57

Cited by 3 publications

(3 citation statements)

References 14 publications

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“…However, underutilization of early warning scores and reluctance to escalate care has been consistently reported in acute care settings. [26][27][28] Research is lacking in the use of EWS tools in the Australian maternity care context despite growing evidence in other countries 25,[29][30][31] that a MEWT can positively impact maternal outcomes and improve morbidity and mortality. This significant gap in current knowledge makes it difficult to appropriately support midwives in gaining the skills and knowledge to recognize and respond to the deteriorating maternal woman, allocate health resources, and develop effective evaluation and quality assurance activities.…”

Section: Introductionmentioning

confidence: 99%

Midwives’ recognition and response to maternal deterioration: A national cross‐sectional study

Ebert

Massey

Flenady

et al. 2022

Birth

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Background: Early warning systems (EWS) are used across health care settings as a tool for the early identification of clinical deterioration and to determine the need to escalate care. Early detection of clinical deterioration and appropriate escalation of care in maternity settings is critical to the safety of pregnant women and infants; however, underutilization of EWS tools and reluctance to escalate care have been consistently reported. Little is known about midwives' use of EWS in the Australian context.

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Section: Introductionmentioning

confidence: 99%

Midwives’ recognition and response to maternal deterioration: A national cross‐sectional study

Ebert

Massey

Flenady

et al. 2022

Birth

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“…To communicate effectively is key to establishing a collaborative relationship with colleagues, particularly in interdisciplinary settings such as in complex care, as adeptly stated by Renfrew and colleagues: "When midwives work in collaboration as part of interdisciplinary teams providing integrated care across community and hospital settings, they also provide effective midwifery care for women and infants who develop complications" (Renfrew et al, 2014, p. 12). Similarly, in the context of Aotearoa NZ, for Dann and Hill (2018) in their assessment of "early warning systems" for alerting rapid deterioration in the health of clients in hospital settings, complex care is no exception. Dann and Hill advocate adopting a "respectful interdisciplinary discourse" (p. 55) to consider the tenets of both midwifery and obstetric practice as key to interdisciplinary collaboration.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2022

nzcomjnl

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Background:Midwives require an expanded level of knowledge and skill to meet the complex care needs of childbearing clients and babies, along with their whānau (extended family and community) throughout their childbearing experience. Complexity in childbirth summons midwives to apply research in practice to support clinical decisions they make. Postgraduate education is key to preparing midwives with a level of expertise in the provision of evidence-based practice, with the view to improving outcomes for women and babies when care becomes complex.Aim: To explore the perceived benefits of midwifery postgraduate education for midwives, women, pregnant people, babies and maternity services, following midwives' completion of a Postgraduate Certificate in Midwifery (Complex Care) offered at an Aotearoa New Zealand university. Method:A purposive sample of 90 midwives who completed the qualification between 2009 and 2017 were sent a link to an online, mixed method, self-report questionnaire. Twenty-seven surveys were returned and entered in Qualtrics for analysis. The qualitative component of the questionnaire is addressed in Question 13 and reported in this article.Findings: A thematic analysis found benefits of postgraduate complex care education included improved quality of care, enhanced knowledge, increased awareness of research, heightened critical thinking capabilities juxtaposed with improved professional development and enhanced communication. Conclusion:The study corroborated the premise that postgraduate midwifery complex care education is key to improving outcomes for childbearing women and babies in settings requiring complex care. Recognition of the benefits of the Postgraduate Certificate in Midwifery (Complex Care) for the provision of evidence-based practice is central to improving health outcomes when pregnancy and childbirth become complex.

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“…Reports spanning more than a decade from professional bodies and other national maternity clinical guidelines recommend using EWS to identify the potential for clinical deterioration in women who are pregnant or postpartum [2][3][4][5][6][7] . These systems have now been widely adopted for use in maternity settings internationally [8][9][10] .…”

Section: Introductionmentioning

confidence: 99%

Early warning systems in maternity care: protocol for a qualitative evidence synthesis of maternity care providers’ views and experiences

2021

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Background: Early warning systems (EWS) have been widely adopted for use in maternity settings internationally. The idea in using these systems is early recognition of potential or actual clinical deterioration in pregnant or postpartum women, and escalation of care. Barriers to successful implementation and use of EWS, however, have been identified. If EWS are to be applied consistently, a greater understanding of the views and experiences of EWS from the perspectives of those using and applying EWS in maternity practice is needed. This protocol describes a qualitative evidence synthesis of maternity care providers’ (midwives, obstetricians, and allied maternity care professionals) views and experiences of EWS use and application in practice. Methods: Studies will be included in the review if they report on maternity care providers use and application of EWS in any birth setting. Qualitative studies and studies of mixed methods design, where qualitative data can be extracted separately, will be included. To source relevant literature the electronic databases of MEDLINE, CINHAL, Web of Science Core Collection (incorporating Social Science Citation Index) and Maternity and Infant Care (MIDIRS), from date of inception, will be searched. The methodological quality of the included studies will be appraised using the 12-criteria of the assessment tool developed by the Evidence for Policy and Practice Information and Co-ordinating Centre. Thematic synthesis will be used for synthesising the qualitative data from included studies. The confidence in the findings will be assessed using the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative research. Conclusions: The findings of this qualitative evidence synthesis may provide valuable information on the barriers, challenges, and facilitators for EWS use based on the experiences of those directly involved in EWS application in maternity care provision. PROSPERO registration: CRD42021235137 (08/04/2021)

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Recognising and responding to acutely deteriorating women in New Zealand maternity wards: A literature and environmental scan

Cited by 3 publications

References 14 publications

Midwives’ recognition and response to maternal deterioration: A national cross‐sectional study

Midwives’ recognition and response to maternal deterioration: A national cross‐sectional study

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Early warning systems in maternity care: protocol for a qualitative evidence synthesis of maternity care providers’ views and experiences

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