Stillbirth in Australia 2: Working together to reduce stillbirth in Australia: The Safer Baby Bundle initiative

Aims: Cytomegalovirus (CMV) is a preventable cause of neurodevelopmental disability. Australian guidelines recommend that pregnant women are informed about CMV to reduce their risk of infection; however, less than 10% of maternity health professionals routinely provide prevention advice. The aim was to develop and evaluate the effectiveness of an eLearning course for midwives to improve knowledge and confidence about CMV. Materials and Methods: Participants undertaking the course between March and November 2020 were invited to complete an evaluation questionnaire: before the course (T1), immediately after (T2) and three months post completion (T3). A linear mixed model was used to evaluate change in participant scores; P < 0.05 was considered statistically significant. Results: Midwives (316/363, 87%), midwifery students (29/363, 8%) and nurses (18/363, 5%) participated. At T1 80% indicated they had not received education about CMV. Total adjusted mean scores for questionnaires completed between T1 (n = 363) and T2 (n = 238) increased significantly (from 17.2 to 22.8, P < 0.001). Limited available T3 scores (n = 27) (−1.7, P < 0.001), while lower than T2, remained higher than at T1 (+3.6, P < 0.001). Participants' awareness of CMV information resources improved from 10 to 97% from T1 to T2. Confidence in providing CMV advice increased from 6 to 95% between T1 and T2 (P < 0.001) and was maintained at T3. Almost all (99%) participants indicated they would recommend the course to colleagues. Conclusion: Participants who completed the eLearning course had significantly improved knowledge and confidence in providing advice about CMV. Programs targeting other maternity health professionals should be considered, to further support the implementation of the congenital CMV prevention guidelines.

Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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eLearning significantly improves maternity professionals’ knowledge of the congenital cytomegalovirus prevention guidelines

Smithers‐Sheedy

Swinburn

Waight

et al. 2022

“…In the absence of one, unintended harm will remain largely invisible. For that reason, the Australian Safer Baby Bundle has recently included our balance measure into their program and evaluation 9,36 . We look forward to seeing whether its reporting in hospitals leads to interventions that improve specificity.…”

Section: Discussionmentioning

confidence: 99%

Preventing harm: A balance measure for improving the detection of fetal growth restriction

Selvaratnam

Wallace

Hunt

et al. 2021

Self Cite

Background Increasing the detection of fetal growth restriction (FGR), while reducing stillbirth, also leads to unnecessary early intervention, and associated morbidity, for normally grown babies who are incorrectly suspected of FGR. Aims We sought to design a balance measure that addresses the specificity of FGR detection. Methods A retrospective cohort study on all singleton births ≥32 weeks gestation in 2016 and 2017 in Victoria. We compared two balance measures for the detection of FGR, defined as the proportion of all babies iatrogenically delivered before 39 weeks gestation for suspected FGR that had a birthweight ≥10th centile (balance measure 1) or ≥25th centile (balance measure 2). Hospital level performance on each balance measure was derived and compared to an existing performance measure for severe FGR detection in Victoria. Results Of the 38 hospitals analysed, 12 (32%) had a favourable performance on an existing indicator of FGR detection, seven (18%) hospitals had a favourable performance on balance measure 1, and 15 (39%) had a favourable performance on balance measure 2. There was a moderate correlation between hospital performance on the existing indicator and on balance measure 1 (r = 0.447, P = 0.005) but not balance measure 2 (r = −0.063, P = 0.71). There was no difference in perinatal mortality between high performing hospitals and low performing hospitals. Conclusion Introducing a balance measure into routine reporting may bring greater awareness to the unintended harm associated with increased detection of FGR.

“…The Centre of Research Excellence in Stillbirth (Stillbirth CRE) has led the development of an Australian bundle of care, the Safer Baby Bundle (SBB), to address the priority evidence practice gaps in stillbirth prevention for implementation across Australian maternity services 5 . The Stillbirth CRE has partnered with leading professional colleges and research institutions across Australia to design a SBB eLearning module, as well as face‐to‐face workshops, to support healthcare professionals in reducing preventable stillbirth.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of an online education module designed to reduce stillbirth

Andrews

Meredith

Seeho

et al. 2021

Self Cite

Background The Safer Baby Bundle (SBB) eLearning is an online education module that addresses practice gaps in stillbirth prevention in Australia. It provides healthcare professionals with evidence‐based resources for: smoking cessation; fetal growth restriction; decreased fetal movements; maternal safe going‐to‐sleep position; and timing of birth for women with risk factors for stillbirth. Aims To determine whether participants’ reported knowledge and confidence in providing care designed to reduce stillbirth changed following completion of the module. To assess the module’s suitability and acceptability, and participants’ reported likelihood to change practice. Materials and methods In‐built surveys undertaken pre‐ and post‐eLearning module assessed participant knowledge and confidence, module suitability and acceptability, and likelihood of practice change using Likert items. Responses were dichotomised. Differences pre‐ and post‐module were tested using McNemar’s test and differences by profession were examined using descriptive statistics and Pearson’s χ2 test. Results Between 15 October 2019 and 2 November 2020, 5223 participants across Australia were included. Most were midwives (82.0%), followed by student midwives (4.6%) and obstetricians (3.3%). Reported knowledge and confidence improved in all areas (P < 0.001). Post‐module 96.7–98.9% ‘agreed’ they had a sound level of knowledge and confidence across all elements of the SBB. Over 95% of participants agreed that the module was helpful and relevant, well organised, and easy to access and use. Eighty‐eight percent reported they were likely to change some aspect of their clinical practice. Conclusions The SBB eLearning module is a valuable education program that is well‐received and likely to result in improvements in practice.