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Retrospective study of birth outcomes for selected primiparous women receiving standard care at The Canberra Hospital compared with those receiving care through the Canberra Midwifery Program (CMP)
Oral Papers / Women and Birth 26 (2013) S1–S21
Retrospective study of birth outcomes for selected primiparous women receiving standard care at The Canberra Hospital compared with those receiving care through the Canberra Midwifery Program (CMP) Wong ∗,1,2 ,
Davis 1,2 ,
Nola Deborah Jenny Browne 2 , Sally Ferguson 2 1 2
Jan
Taylor 2 ,
Canberra Hospital, Canberra, Australia University of Canberra, Canberra, Australia
The aim of this research is to inform our understanding of the clinical outcomes of selected primiparous women accessing varying maternity models of care at The Canberra Hospital in order to determine best practice and assist future planning: to compare a retrospective cohort of selected primiparous women who have accessed the Canberra Midwifery Program (CMP) with those who received standard public care at The Canberra Hospital. The study was conducted using data collected from records held by The Canberra Hospital for the period 1 January 2010 to 31 December 2011 and aimed to determine: whether the clinical outcomes for selected primiparous women differ between those women receiving standard public maternity care and those receiving care from a known midwife or midwives in the CMP. The primary outcome of interest is mode of birth (vaginal, assisted vaginal, operative) and the secondary outcomes include; augmentation of labour, postpartum haemorrhage, perineal trauma, 5 minuteApgar score <7, neonatal admission to the Neonatal Intensive Care Unit (NICU), stillbirth/neonatal death, length of hospital stay and breastfeeding within an hour of birth. The statistically significant differences in outcomes include increased rates of spontaneous vaginal birth, reduced analgesic (including narcotic) use in labour and transfer home within twenty four hours for the CMP group. If it is possible to provide evidence that continuity of care/carers improves the spontaneous vaginal birth rate in selected primiparas, it has far-reaching implications not only for the woman and her family but also for the organisation. Having birthed without intervention the first time, her child-bearing future is almost assured and this has physical, psychological and financial implications for her future. Because she is able to go home early in the care of her known midwife, it also has cost saving implications for the organisation. http://dx.doi.org/10.1016/j.wombi.2013.08.068
S21
Reach, effectiveness and sustainability of a Safe Infant Sleeping eLearning program Jeanine Young ∗,1 , Niall Higgins 1,2 , Leanne Raven 3 1
RCCCPI, Griffith University, Brisbane, Australia Clinical Skills Development Service, Queensland Health, Brisbane, Australia 3 SIDS and Kids Australia, Melbourne, Australia 2
Midwives have a key role in supporting safe sleeping recommendations demonstrated to reduce Sudden Unexpected Deaths in Infancy (SUDI). Reach, sustainability and effectiveness of an evidence-based eLearning program in positively impacting knowledge and knowledge application relating to SUDI and safe sleeping recommendations were evaluated. A pre-test/post-test design evaluated knowledge and knowledge application in a sample of health professionals, predominantly nurses and midwives, who completed the 3-module Safe Infant Sleeping eLearning program. The program includes SUDI risk factors, evidence underpinning public health recommendations and parent advice. Interactive audio and visual components reinforced learning objectives and an in-built evaluation measured prior knowledge and learning outcomes. Pre-test–post-test changes were analysed using paired t-tests; sample subsets were compared using independent t-tests. During the first 2.5 years in operation (June 2010–December 2012) the program attracted 5280 registrations with 2244 completions. The program targeted Queensland health professionals however attracted attention from other states and overseas. Participants were predominantly nurses and midwives (n = 2051) however included allied health, medical, student, parent, child health worker, Indigenous Health worker and SIDS and Kids employees. Pretest results (n = 2244) identified deficits in knowledge and application to risk factor assessment and evidence-based parent advice. Participant scores significantly increased post-test [pretest 69.5% vs post-test average 87%, p < 0.0001). Public sector staff were significantly higher pretest than private sector (69.9% vs 64%, p < 0.0001), however post-test scores were similar (86.7% vs 87.4%, p = 0.2). Nurses and midwives scored higher than other professional groups pretest; while post-test mean scores were similar between the two groups (87% vs 87%, p = 0.5). This innovative program was sustainable, effective and attractive to a broad health professional group. Consistent delivery of evidence-based information relating to safe sleeping and linking key policy will support midwives in their role as parent educators about public health initiatives that promote infant health and reduce mortality. http://dx.doi.org/10.1016/j.wombi.2013.08.281
Retrospective study of birth outcomes for selected primiparous women receiving standard care at The Canberra Hospital compared with those receiving care through the Canberra Midwifery Program (CMP) Wong ∗,1,2 ,
Davis 1,2 ,
Nola Deborah Jenny Browne 2 , Sally Ferguson 2 1 2
Jan
Taylor 2 ,
Canberra Hospital, Canberra, Australia University of Canberra, Canberra, Australia
The aim of this research is to inform our understanding of the clinical outcomes of selected primiparous women accessing varying maternity models of care at The Canberra Hospital in order to determine best practice and assist future planning: to compare a retrospective cohort of selected primiparous women who have accessed the Canberra Midwifery Program (CMP) with those who received standard public care at The Canberra Hospital. The study was conducted using data collected from records held by The Canberra Hospital for the period 1 January 2010 to 31 December 2011 and aimed to determine: whether the clinical outcomes for selected primiparous women differ between those women receiving standard public maternity care and those receiving care from a known midwife or midwives in the CMP. The primary outcome of interest is mode of birth (vaginal, assisted vaginal, operative) and the secondary outcomes include; augmentation of labour, postpartum haemorrhage, perineal trauma, 5 minuteApgar score <7, neonatal admission to the Neonatal Intensive Care Unit (NICU), stillbirth/neonatal death, length of hospital stay and breastfeeding within an hour of birth. The statistically significant differences in outcomes include increased rates of spontaneous vaginal birth, reduced analgesic (including narcotic) use in labour and transfer home within twenty four hours for the CMP group. If it is possible to provide evidence that continuity of care/carers improves the spontaneous vaginal birth rate in selected primiparas, it has far-reaching implications not only for the woman and her family but also for the organisation. Having birthed without intervention the first time, her child-bearing future is almost assured and this has physical, psychological and financial implications for her future. Because she is able to go home early in the care of her known midwife, it also has cost saving implications for the organisation. http://dx.doi.org/10.1016/j.wombi.2013.08.068
S21
Reach, effectiveness and sustainability of a Safe Infant Sleeping eLearning program Jeanine Young ∗,1 , Niall Higgins 1,2 , Leanne Raven 3 1
RCCCPI, Griffith University, Brisbane, Australia Clinical Skills Development Service, Queensland Health, Brisbane, Australia 3 SIDS and Kids Australia, Melbourne, Australia 2
Midwives have a key role in supporting safe sleeping recommendations demonstrated to reduce Sudden Unexpected Deaths in Infancy (SUDI). Reach, sustainability and effectiveness of an evidence-based eLearning program in positively impacting knowledge and knowledge application relating to SUDI and safe sleeping recommendations were evaluated. A pre-test/post-test design evaluated knowledge and knowledge application in a sample of health professionals, predominantly nurses and midwives, who completed the 3-module Safe Infant Sleeping eLearning program. The program includes SUDI risk factors, evidence underpinning public health recommendations and parent advice. Interactive audio and visual components reinforced learning objectives and an in-built evaluation measured prior knowledge and learning outcomes. Pre-test–post-test changes were analysed using paired t-tests; sample subsets were compared using independent t-tests. During the first 2.5 years in operation (June 2010–December 2012) the program attracted 5280 registrations with 2244 completions. The program targeted Queensland health professionals however attracted attention from other states and overseas. Participants were predominantly nurses and midwives (n = 2051) however included allied health, medical, student, parent, child health worker, Indigenous Health worker and SIDS and Kids employees. Pretest results (n = 2244) identified deficits in knowledge and application to risk factor assessment and evidence-based parent advice. Participant scores significantly increased post-test [pretest 69.5% vs post-test average 87%, p < 0.0001). Public sector staff were significantly higher pretest than private sector (69.9% vs 64%, p < 0.0001), however post-test scores were similar (86.7% vs 87.4%, p = 0.2). Nurses and midwives scored higher than other professional groups pretest; while post-test mean scores were similar between the two groups (87% vs 87%, p = 0.5). This innovative program was sustainable, effective and attractive to a broad health professional group. Consistent delivery of evidence-based information relating to safe sleeping and linking key policy will support midwives in their role as parent educators about public health initiatives that promote infant health and reduce mortality. http://dx.doi.org/10.1016/j.wombi.2013.08.281