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Showing results for tags 'Maternity'.
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Content ArticleAre you applying Safety-II principles to improve safety in maternity, A&E, ICU or anaesthetics? If so, Dr Ruth Baxter would love to interview you!
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Content ArticleUnsafe maternity care has cost the National Health Service in England (NHS) £8.2bn in 15 years. How many more surveys of women’s experiences, reports of poor quality care and failings of senior management at NHS maternity units do we need to know that there is still a massive problem with maternity services in England? Judy Shakespeare, Elizabeth Duff and Debra Bick discuss why a joined-up policy and investment in maternity services is urgently needed.
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Content ArticleThis document outlines the terms of reference for the independent review into maternity services at Nottingham University Hospitals NHS Trust (NUH), commissioned by NHS England and led by Donna Ockenden. The review has been established in light of significant concerns raised about the quality and safety of maternity services at NUH, and concerns voiced by local families. It replaces a previous regionally-led review after some families expressed concerns and made representations to the Secretary of State for Health and Social Care. The review began on 1 September 2022 following early engagement with families and NUH from June 2022. It is expected to last 18 months, although this timeframe is subject to review. Learning and recommendations will be shared with NUH as they become apparent, to allow rapid action to improve the safety of maternity care. The only and final report is expected to be published and presented to NUH and NHS England around March 2024.
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Content ArticleMidwives, public health nurses and practice nurses are in an ideal position to address mental health and emotional well-being with women in the perinatal period. However, research involving midwives, public health nurses and practice nurses in Ireland indicates that there is considerable variation in perinatal mental health assessment and care. All three groups identify the following issues as barriers to addressing perinatal mental health issues: Lack of knowledge on the range of perinatal mental health problems Lack of skill in opening a discussion and developing a plan of care with women Organisational issues, such as lack of policies, guidelines and care pathways This document produced by the Irish Health Service Executive, aims to provide an evidence-based guidance document for midwives, public health nurses and practice nurses in the area of perinatal mental health care.
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Content ArticleMedication errors are any Patient Safety Incidents (PSI) where there has been an error in the process of prescribing, preparing, dispensing, and administering, monitoring or providing advice on medicines. Medication errors can occur at many steps in patient care, from ordering the medication to the time when the patient is administered the drug. From April 1 2015 to 31 March 2020 NHS Resolution received 1,420 claims relating to errors in the medication process. Of those claims, 487 claims settled with damages paid, costing the NHS £35 million (excluding legal costs). NHS Resolution initial data for medication errors indicates that anticoagulants, opioids, antimicrobials, antidepressants, and anticonvulsants are the most common medications to be implicated in incidents.
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Content ArticleThe purpose of this investigation by the Healthcare Safety Investigation Branch (HSIB) was to consider the management and care of preterm labour and birth of twins. Preterm birth—defined as babies born alive before the completion of 37 weeks of pregnancy—is one of the main causes of death, long-term conditions and disability in under-fives worldwide, and 60% of twin pregnancies result in premature birth. The reference event for this investigation was the case of Sarah, who was pregnant with twins and was overseen by an obstetrician during her pregnancy. Sarah was assessed as having a higher-risk pregnancy as she had had previous medical intervention on her cervix and was pregnant with twins. Shortly after having been discharged from a hospital with a specialist neonatal unit following suspected early labour, she went to her local maternity unit at 29+2 weeks with further episodes of abdominal tightening. Her labour did not progress as expected and a caesarean section was required to deliver the babies at 29+6 weeks. The twin girls were born well, but 23 days after their birth a scan revealed brain injury in both babies. The investigation identified several findings to explain the experience of the mother in the reference event, including the lack of scientific evidence or specific guidelines and the uncertainty associated with the clinical decision making in this scenario. This highlighted the need for further research into preterm labour as a recognised risk factor for twin pregnancies. As part of the investigation, HSIB identified that since 2019 a large volume of national work and research in the area of twin pregnancy and preterm birth has been undertaken. The investigation report sets out the work currently in progress and seeks to understand if it will address gaps in knowledge.
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Content ArticleThis article and video tell the story of Rihan Neupane, a baby born prematurely in Dhapasi, Nepal, who was left in a vegetative state following a series of medical errors including a missed diagnosis of meningitis. His parents had chosen a private international hospital for their maternity care, but were let down by a series of medical errors including Rihan being mistakenly given a massive paracetamol overdose. Although external hospital safety inspectors found the hospital negligent on many counts, the hospital continued to deny any wrongdoing or responsibility for Rihan's condition. Rihan's father Sanjeev Neupane talks about his family's experience in the embedded video.
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Content ArticleIn this article, Maryanne Demasi looks at the continued prescription of Makena, an injectable synthetic hormone approved by the US Food and Drug Administration (FDA) to women who are at high-risk of premature delivery. Makena claims to reduce the risk of pre-term birth and was approved in 2011 on an accelerated pathway by the FDA following an initial trial that showed positive outcomes. However, Demasi explains, the study has been discredited as flawed in its methods and findings, and a confirmatory trial conducted by the manufacturer showed that Makena does not actually prevent preterm birth. In spite of this, and in the face of known risks, Makena is still being prescribed to pregnant women as the manufacturer has refused to withdraw it from the market. She highlights the dangers of the FDA not taking stronger action against the manufacturer of Makena, by looking at the example of Diethylstilbestrol (DES), a synthetic hormone use by women from the 1930's to the 1970s to prevent miscarriages and premature births. DES was later found to cause cancers, immune and cardiovascular disorders and other abnormalities in pregnant women, their children and their grandchildren.
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Content ArticleThis leaflet produced by Group B Strep Support and the Royal College of Obstetrics and Gynaecology provides information about group B Strep (GBS) aimed particularly at pregnant women. It includes; an explanation of what group B Strep is. what GBS could mean for a baby. how to reduce the risk of GBS infection to a baby. a list of the signs of GBS infection in newborn babies.
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Content ArticleThis report by Richard Norrie, director of the Statistics and Policy Research Programme at Civitas, aims to scrutinise the Race and Health Observatory (RHO) rapid evidence review into ethnic inequalities in healthcare published in February 2022. The report highlights inconsistencies in the review's use of research and data and argues that its conclusions do not reflect the full body of evidence available concerning race and health outcomes. The author suggests that the review makes a false assumption that the needs of all ethnic groups are the same, which leads to its potentially inaccurate conclusions about the prevalence and causes of health inequalities.
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Birthrights are receiving an increasing number of enquiries regarding restrictions of maternity services due to the staffing crisis, including closure of midwifery-led units and homebirth services. In order to get a full picture, including a regional overview, Birthrights would like to know if your local maternity service has been restricted in any way. To help gather evidence, Birthrights are calling for anyone who knows what the current situation is at their local Trust, including whether staffing is leading to: Their homebirth service being restricted. Their Midwife-Led Unit being closed. To take part follow the link below. -
Content ArticleThis report provides a review of the Healthcare Safety Investigation Branch (HSIB) maternity investigation programme during 2021/22, including an overview of activity during this period, themes arising from investigations and plans for the future. It is intended for healthcare organisations, policymakers and the public to understand the work HSIB have undertaken.
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Content ArticleIn this blog, Charlotte Clayton, midwife and clinical advisor at the Organisation for the Review of Care and Health Apps (ORCHA), explores how providing the right training and support for maternity staff is key to seeing the benefits tech can bring to quality of care and workload.
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Content ArticleThe Birth Injury Help Center is a US-based online resource centre that provides information on birth injuries, as well pregnancy and childbirth. This article provides information for pregnant women about foods, drinks, medications and activities to avoid during pregnancy.
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Content ArticleThe government has published the first ever Women's Health Strategy for England to tackle the gender health gap.
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Content ArticleOn 1 November 2022, Dr Bill Kirkup, HSIB's Clinical Director of Maternity Investigations, and lead investigator for the investigation into maternity and neonatal services at East Kent Hospitals University NHS Foundation Trust, presented the investigation report: 'Reading the signals' in a seminar delivered to HSIB staff.
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Content ArticleWomen are four times as likely to die after childbirth in Britain as in Scandinavian countries, a study published in the BMJ from Diguisto et al. has found. The authors compared maternal mortality in eight countries (France, Italy, UK, Denmark, Finland, the Netherlands, Norway, and Slovakia) with enhanced surveillance systems. They found that UK had the second-highest death rate, with one in 10,000 mothers dying within six weeks of giving birth, only slightly less than in Slovakia, the worst performing. Norway has the lowest maternal death rates in Europe, at one in 37,000. In Denmark, the second-best performing country, one in 29,000 died. In-depth analyses of differences in the quality of care and health system performance at national levels are needed to reduce maternal mortality further by learning from best practices and each other. Cardiovascular diseases and mental health in women during and after pregnancy must be prioritised in all countries.
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Published on 19 October 2022, the report of the investigation into maternity and neonatal services at East Kent Hospitals NHS Foundation Trust revealed a series of serious patient safety failings between 2009 and 2020, which resulted in avoidable harm to patients and deaths. The investigation found that if nationally recognised standards had been followed, the outcome could have been different in 97 of the 202 cases reviewed. In this article, Patient Safety Learning analyses the findings of this report from a broad patient safety perspective, focusing on five key themes that are consistent with many other serious patient safety inquiries and reports in recent years. It sets these in their wider context and highlights the need for a fundamental transformation in our approach to patient safety if similar scandals are to be prevented in the future.- Posted
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Content ArticleEstablished in 2006, the National Neonatal Audit Programme (NNAP) is commissioned by the Healthcare Quality Improvement Partnership (HQIP) and delivered by the Royal College of Paediatrics and Child Health (RCPCH). It assesses whether babies admitted to neonatal units receive consistent high-quality care in relation to the NNAP audit measures that are aligned to a set of professionally agreed guidelines and standards. The NNAP also identifies variation in the provision of neonatal care at local unit, regional network and national levels and supports stakeholders to use audit data to stimulate improvement in care delivery and outcomes. This report summarises the key messages and national recommendations developed by the NNAP Project Board and Methodology and Dataset Group, based on NNAP data relating to babies discharged from neonatal care in England and Wales between January and December 2021.
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Content ArticleThe MBRRACE-UK collaboration, led from Oxford Population Health's National Perinatal Epidemiology Unit (NPEU), has published the results of their latest UK Confidential Enquiry into Maternal Deaths and Morbidity. These annual rigorous reports are recognised as a gold standard in identifying key improvements needed for maternity services. The latest Saving Lives, Improving Mothers' Care analysis examines in detail the care of all women who died during, or up to one year after, pregnancy between 2018 and 2020 in the UK. This is the first report to include data that demonstrates the impact of the COVID-19 pandemic on maternal deaths.
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Content ArticleOn 19 October 2022, the long-awaited findings of Dr Bill Kirkup’s independent investigation into maternity services at East Kent were published. This blog outlines the response of the charity Birthrights to the investigation. It focuses on how breaches of mothers' human rights contributed to negative experiences of care and affected outcomes. Lack of informed consent, the use of disrespectful and discriminatory language and a failure to listen to mothers' concerns all contributed to many cases of avoidable harm. It argues that there is a desperate need for proper funding and real commitment to improving staff recruitment and retention, coupled with a culture shift in maternity care that embeds human rights at the centre of care.
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Content ArticleInflammatory rheumatic disease (IRD), such as rheumatoid arthritis, can cause poor outcomes in pregnancy, and the health of the mother and developing foetus must be balanced when making decisions about medication. This updated guideline from the British Society for Rheumatology contains evidence and best practice for prescribing rheumatology medications during pregnancy and breastfeeding. It includes a table that summarises information about drug compatibility in pregnancy and breastfeeding.
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Content ArticleAppreciative Inquiry (AI) is a research approach that aims to create practical and collaborative change by taking participants through an in-depth exploration of their organisation, team or role. This article in the European Journal of Midwifery reflects on the process of using AI in a study that explored staff wellbeing in a UK maternity unit. The authors share key lessons to help others decide whether AI will fit their research aims, and highlight issues in its design and application.
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Content ArticleMaternity costs make up the largest cost to the NHS in value of claims. The Early Notification Scheme provides a faster and more caring response to families whose babies may have suffered severe harm. 'The second report: The evolution of the Early Notification Scheme' provides an overview of progress made since the report into the first year of the scheme, which was published in 2019. The report updates on the progress of the key recommendations which were made in the first report and reflects on modifications and improvements made to the scheme since its launch five years ago. It provides an analysis of the main clinical themes, based on a small cohort of cases, and makes recommendations to further improve outcomes for affected families.
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Content ArticleIn this article for The Times, Deborah Ross describes her negative experience of NHS maternity care during and after labour, and how this has put her off having more children. During her 72-hour labour and subsequent hospital admission, she was denied pain relief, did not feel listened to and was not informed as to why her baby had been transferred to NICU.
