Supporting healthy weight gain and management in pregnancy: Does a mandatory training education session improve knowledge and confidence of midwives?

Jersey, Susan de; Tyler, Jeanette; Guthrie, Taylor; New, Karen

doi:10.1016/j.midw.2018.06.025

Cited by 25 publications

(53 citation statements)

References 20 publications

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“…The session was based on the ‘5As’ framework for behaviour change and covered on the risks of unhealthy GWG, communication strategies, key guideline and local practice recommendations to support women in attaining healthy lifestyle habits and GWG. Details of the training and evaluation have been published elsewhere …”

Section: Methodsmentioning

confidence: 99%

“…In recent years, there has been increasing attention toward the need for targeted education and training for healthcare professionals . While it is known that providing training is important and can improve the knowledge, confidence and intention for guideline adherence in antenatal staff, research on its translation to changes in healthcare practices remains limited …”

Section: Introductionmentioning

confidence: 99%

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

Yim

Guthrie

Jersey

2019

Aust NZ J Obst Gynaeco

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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

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Yim

Guthrie

Jersey

2019

Aust NZ J Obst Gynaeco

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“…It was expected that all women with a singleton pregnancy would have a chart established by the midwife conducting the initial hospital assessment, and that weight would be measured and plotted on the chart throughout pregnancy. The implementation of the charts was supported by mandatory training for midwives (de Jersey et al, ), and a 15 min voice over PowerPoint presentation, available to all health professionals on computers in all work areas, provided guidance on the use of the charts and tips to support women achieve a healthy weight gain in pregnancy. The training addressed key barriers to routine weight monitoring and communicating with women about weight identified by midwives in a series of focus groups.…”

Section: Methodsmentioning

confidence: 99%

“…The training addressed key barriers to routine weight monitoring and communicating with women about weight identified by midwives in a series of focus groups. The training content has been described in detail previously (de Jersey et al, ). Emails were disseminated through midwifery and medical leads to inform HCPs of the availability of the training in addition to in‐services in outpatient work areas.…”

Section: Methodsmentioning

confidence: 99%

A mixed method study evaluating the integration of pregnancy weight gain charts into antenatal care

Jersey

Guthrie

Tyler

et al. 2018

Maternal & Child Nutrition

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Monitoring pregnancy weight can reduce excess gestational weight gain (GWG), and is recommended in clinical practice guidelines as part of routine care. This study aimed to evaluate the implementation of routine weight monitoring using a pregnancy weight gain chart (PWGC), and assess health care professionals (HCPs) and pregnant women's attitudes and practices around its use. A semiquantitative survey was conducted with a consecutive sample of antenatal women at 16 and 36 weeks gestation.Women were weighed, and a PWGC audit done at 36 weeks gestation to assess adherence to chart use and GWG. A cross-sectional survey of antenatal HCPs at the Australian facility assessed staff attitudes and practices relating to weight monitoring and PWGC use. Of the 291 women surveyed, 68% reported being given a PWGC. Of the audited PWGCs (n = 258), 54% had less than three weights recorded, 36% had errors, and 3% were unused. All HCPs surveyed (n = 42) were aware of the PWGC, 63% reported using it to track GWG regularly and 26% believed it to be only the woman's responsibility (i.e., not the midwife's role) to complete it. Seventysix percent reported they needed more training in counselling pregnant women, and insufficient time was a main barrier to weighing and conversing with women. It is feasible to implement a PWGC into routine antenatal care. Clarity over women's and HCPs responsibility for monitoring GWG and completion of the PWGC is needed.Training on correct PWGC use and counselling and workforce engagement are required to overcome barriers and support healthy GWG.

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“…Survey instrument : The questionnaire was developed using items adapted from the Normalisation MeAsure Development (NoMAD) tool and similar local questionnaires . Feedback on the draft survey was gathered from a senior dietetic clinician researcher experienced in survey development, a clinical dietitian experienced in enteral tube feeding and TF and a student clinician to ensure content and face validity with appropriate modifications made.…”

Section: Methodsmentioning

confidence: 99%

Improving nutrition care for neurosurgery patients through a nurse‐led transition feeding protocol

Dux

Lim

Jeffree

et al. 2019

Nutrition & Dietetics

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Aim Neurosurgical patients often transition from enteral nutrition (EN) to oral nutrition (ON) as they recover. Implementing a nurse‐led feeding protocol to guide this transition may improve consistency of nutrition care and dietitian workload efficiency. This pragmatic study aimed to evaluate the effect of such a protocol on these outcomes and on nurses’ nutrition care attitudes, practices and knowledge. Methods Data were collected retrospectively for 1 year pre‐ and prospectively for 1 year post‐implementation of the transition feeding protocol (TFP). Participants who transitioned from EN to ON were included in the study. Post‐implementation nurses in the neurosurgery ward were invited to complete a self‐administered questionnaire to investigate attitudes, practices and knowledge. Results One hundred and thirteen participants, 55 pre‐ and 58 post‐implementation, took part in the study. Significantly more patients received transition feeding (TF) post‐implementation (58% vs 93%, P < 0.001), there was a statistically significant improvement in the commencement of TF (0 vs 1 day after ON clearance; P = 0.029), and all patients consumed adequate oral intake 1‐week post‐EN cessation (92.3% vs 100%, P = 0.078). There was no difference in dietetic occasions of service post‐implementation (2 vs 1.5; P = 0.204). A 38% survey response rate from nursing staff (n = 15) was achieved. More nurses were found to be initiating TF (P < 0.001) and a majority reported a perceived increase in knowledge and confidence in providing nutrition support. Conclusions A TFP can optimise the transition from EN to ON by improving consistency and commencement of TF and nurses’ confidence and knowledge in overall nutrition care.

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Supporting healthy weight gain and management in pregnancy: Does a mandatory training education session improve knowledge and confidence of midwives?

Cited by 25 publications

References 20 publications

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

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

A mixed method study evaluating the integration of pregnancy weight gain charts into antenatal care

Improving nutrition care for neurosurgery patients through a nurse‐led transition feeding protocol

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