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Showing results for tags 'Obstetrics and gynaecology/ Maternity'.
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Content ArticleNational Learning Reports offer insight and learning about recurrent patient safety risks in NHS healthcare that have been identified through HSIB investigations. They present a digest of relevant, previously investigated events, highlight recurring themes and, where appropriate, make safety recommendations. National learning reports can be used by healthcare leaders, policymakers and the public to aid their knowledge of systemic patient safety risks and the underlying contributory factors, and to inform decision making to improve patient safety. The Healthcare Safety Investigation Branch (HSIB) Summary of themes arising from HSIB maternity investigation programme report (March 2020) describes eight themes arising from the maternity investigations. Sudden unexpected postnatal collapse (SUPC) was identified as a theme for further exploration in order to highlight areas of system-wide learning. SUPC is a rare but potentially fatal event in otherwise healthy appearing term (born after 37 completed weeks) newborn babies at birth. Between April 2018 and August 2019 HSIB completed 335 maternity investigations. Of the 12 identified SUPC cases, there were 6 cases where positioning of the baby to achieve skin-to-skin contact may have contributed to SUPC. While the number of incidents found was small compared to the number of term babies who had skin-to-skin contact at birth these incidents may in future be avoided and so learning is essential.
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Content ArticleIn this editorial for the British Medical Journal, Helen Haskell summarises the findings and recommendations of the Cumberlege Review, First Do No Harm. Helen argues that while the report has the potential to be a powerful tool for change in and beyond the UK, patients and families now need to see evidence of action.
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- Womens health
- Health inequalities
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Content ArticleThis document was drafted on the basis of the Transparency Committee opinion, French National Authority for Health, dated 27 February 2019. It found insufficient clinical benefit of ESMYA* for the treatment of uterine fibroids to justify reimbursement. They conclude: The actual clinical benefit of ESMYA is insufficient to justify its reimbursement by public funding in its two indications. Not approved for non-hospital pharmacy reimbursement or for hospital treatment. *ESMYA - (ulipristal acetate), progesterone receptor modulator.
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- Womens health
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Content ArticleFor 10 years, 29-year-old historian Robyn battled extreme endometriosis pain, but was continuously dismissed by doctors when she went to them for help. She was finally diagnosed with the condition – but five surgeries later, it was clear the damage had already been done. In this article published by Stylist, she asks why women’s health issues aren’t being taken seriously enough.
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- Womens health
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Content ArticleThe goal of this US-based study, published in Psychiatric Services, was to characterise racial-ethnic differences in mental health care utilisation associated with postpartum depression in a multi-ethnic cohort of Medicaid recipients. Medicaid in the United States is a federal and state program that helps with medical costs for some people with limited income and resources. Findings of the study presents evidence of low rates of postpartum depression treatment initiation and continuation, indicating barriers to care among low-income mothers; racial-ethnic disparities imply additional challenges for black women and Latinas. The presence of such disparities points to the need for clinical and institutional policies and programs to address the particular barriers to mental health care faced by black women and Latinas in the months after delivery.
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- Obstetrics and gynaecology/ Maternity
- Maternity
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Content ArticleThis paper, from THIS Institute, aims to describe exactly what needs to happen for maternity care to be safe by examining how interventions and context work together to nurture and sustain safe practice.
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- Maternity
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Content ArticleChaired by Baroness Julia Cumberlege, the Independent Medicines and Medical Devices Safety Review report, First Do No Harm, examines how the healthcare system in England responds to reports about the harmful side effects from medicines and medical devices. In this blog, Patient Safety Learning reflects on one of the key patient safety themes featured in the Review – informed consent.
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- Womens health
- Patient harmed
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Content Article
The Obs Pod, by obstetrician Florence Wilcock
PatientSafetyLearning Team posted an article in Maternity
This series of podcasts, supported by the Maternity Experience (#MatExp), is produced by Florence Wilcock. She explores different topics within maternity, aiming to ignite positive change and action.- Posted
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- Obstetrics and gynaecology/ Maternity
- Quality improvement
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Content ArticleMore women are choosing to birth at home in well-resourced countries. Concerns persist that out-of-hospital birth contributes to higher perinatal and neonatal mortality. This systematic review, published by The Lancet, and meta-analyses determines if risk of fetal or neonatal loss differs among low-risk women who begin labour intending to give birth at home compared to low-risk women intending to give birth in hospital.
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Content Article
The group B Strep i-learn module
PatientSafetyLearning Team posted an article in Maternity
Group B Strep can be a complex topic, with some confusion about what exactly is the latest guidelines on testing, risk factors, recommended antibiotics, and the impact (if any) of GBS on homebirths, waterbirths, breastfeeding, and much more.This is why Group B Strep Support and the Royal College of Midwives (RCM) have produced an evidence-based group B Strep i-learn module.The group B Strep i-learn module focuses on the current UK guidelines for preventing group B Strep infection in newborn babies and on signs of these infections in babies. It will refresh clinician knowledge of the national guidelines, and help you tackle the FAQs you get from expectant and new parents.Follow the link below to find out how to sign up.- Posted
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Content ArticleCOVID-19 has created unprecedented pressures for the NHS as a whole including maternity services. How can maternity leaders run a safe and rights respecting maternity service during a pandemic? This guide, produced by Brithrights, sets out a process to support maternity service leaders to reach decisions that help them to achieve this. All those affected by decisions need to be involved in making them. NHS England guidance states that Maternity Voices Partnership Chairs should be involved in decisions about temporary changes to maternity services, in addition to staff and partner organisations.
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Premature Waters Breaking (PPROM awareness)
PatientSafetyLearning Team posted an article in Maternity
PPROM is the acronym for Preterm Pre-labour Rupture Of Membranes. This is otherwise known as when the waters break prior to 37 weeks during pregnancy. These waters, known as the amniotic fluid, protect the baby from injury. It also helps in preventing infection being passed from mother to baby. As soon as the waters break the risks of infection to both mother and baby are high. Therefore good management of care at this stage is key to treating this condition successfully. Little Heartbeats raise awareness of PPROM, help patients share their experiences and promote the use of the Royal College of Obstetricians and Gynaecology leaflet which contains the guidelines set out for UK hospitals to follow in the event of PPROM. -
Content ArticleWhen patients give feedback to healthcare providers, the topic of "communication" often features prominently. That is because when people are feeling vulnerable, the way they are spoken to, and the words that are used, matter a great deal. There can be few experiences that are more distressing than the death of a baby. So we need to think very carefully about how bereaved parents are spoken to. This paper looks at clinical terms such as "miscarriage", "stillbirth" and "neo-natal death" and finds that "These categorisations based on gestational age and signs of life may not align with the realities of parental experience". This study, published by the International Journal of Obstetrics and Gynaecology, explored the healthcare experiences of parents whose babies had died just before 24 weeks of gestation. Those interviewed "felt strongly that describing their loss as a "miscarriage" was inappropriate and did not adequately describe their lived experience".
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- Communication
- Patient factors
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Risks of CTG monitoring
PatientSafetyLearning Team posted an article in Maternity
This is a series of three articles written by Kirsten Small, a specialist obstetrician and gynaecologist in Australia, exploring the risks that flow from the use of intrapartum monitoring. Part 1 Examines evidence of short and long-term physical harms to birthing women relating to higher rates of surgical birth when intrapartum Cardiotocography (CTG) monitoring is used. Part 2 Focuses on possible psychological harms which have been reported relating to CTG use. Part 3 Looks at the possibility that CTG use might cause harm to the baby, while the two previous posts have examined the risk to birthing women.- Posted
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- Maternity
- Obstetrics and gynaecology/ Maternity
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Content ArticleIn this candid blog, 'The Secret Midwife', gives her account of the pressure and lack of resource and support that makes it so difficult to provide safe care.
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- Obstetrics and gynaecology/ Maternity
- Maternity
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Content ArticleDespite increasing recognition of the potential risks associated with in-hospital newborn falls among health professionals, new parents are frequently unaware of the possibility of dropping their newborn, especially in the hospital. Although most newborn falls do not result in lasting harm to the newborn, they may need additional healthcare services and cause stress to the parents.
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- Baby
- Obstetrics and gynaecology/ Maternity
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Content ArticleThis article, published by Medium, looks at the story of a woman who had a stroke while pregnant. Both survived. The authors highlight a growing concern that the US is in the midst of a maternal morbidity and mortality crisis.
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- Maternity
- Obstetrics and gynaecology/ Maternity
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Content ArticlePublished in Acta Paediatrica, the parents of a baby who was born prematurely and died, share their experiences of the communication and choices given to them before the birth.
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- Baby
- Obstetrics and gynaecology/ Maternity
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Content Article
Consent: The Montgomery Ruling (2015)
Claire Cox posted an article in Consent issues
The Montgomery case in 2015 was a landmark for informed consent in the UK. Nadine Montgomery, a diabetic woman and of small stature, delivered her son vaginally; her son experienced complications owing to shoulder dystocia, resulting in hypoxic insult with consequent cerebral palsy. Her obstetrician had not disclosed the increased risk of this complication in vaginal delivery, despite Montgomery asking if the baby's size was a potential problem. Montgomery sued for negligence, arguing that, if she had known of the increased risk, she would have requested a caesarean section The Supreme Court of the UK announced judgement in her favour in March 2015. It established that, rather than being a matter for clinical judgment to be assessed by professional medical opinion, a patient should be told whatever they want to know, not what the doctor thinks they should be told. This ruling means that patients can expect a more active and informed role in treatment decisions, with a corresponding shift in emphasis on various values, including autonomy, in medical ethics- Posted
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- Consent
- Perception / understanding
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Content Article
Each baby counts: Aims and objectives
Claire Cox posted an article in Maternity
In the UK, each year over 1000 babies die or are left with severe brain injury, not because they are born too soon or too small, or have a congenital abnormality, but because something goes wrong during labour. The Royal College of Obstetricians and Gynaecologists does not accept that all of these are unavoidable tragedies, and with the Each baby counts project, they are aiming to reduce this unnecessary suffering and loss of life by 50% by 2020.- Posted
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- Delivery suite
- Maternity
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Content Article
RCOG: Video briefing on human factors and situational awareness
Claire Cox posted an article in Maternity
Each baby counts is the Royal College of Obstetricians and Gynaecologist's national quality improvement programme to reduce the number of babies who die or are left severely disabled as a result of incidents occurring during term labour. Watch the Each baby counts human factors video for information on how to address issues within your unit. -
Content ArticleToo often, women are struggling to get the right information they need about their health, to book routine appointments and to get their basic health needs met. Health services miss opportunities to ask the right questions, prevent illness and ensure the best outcomes for girls and women. This report from the Royal College of Obstetricians and Gynaecologists (RCOG) follows a survey of over 3000 women in the UK and identifies simple and cost-effective solutions to prevent girls and women falling through the cracks of our health systems. A strategic approach is required across the life course to prevent predictable morbidity and mortality and to address the determinants of health specific to women’s health.
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- Obstetrics and gynaecology/ Maternity
- Process redesign
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Content ArticleIn this study published in BMJ Open, Bourne et al. determined the prevalence of burnout in doctors practising obstetrics and gynaecology, and assess the association with defensive medical practice and self-reported well-being. They carried out a nationwide online cross-sectional survey study of 5661 practising obstetrics and gynaecology consultants, specialty and associate specialist doctors and trainees registered with the Royal College of Obstetricians and Gynaecologists, between December 2017 and March 2018. They found high levels of burnout were observed in obstetricians and gynaecologists and particularly among trainees. Burnout was associated with both increased defensive medical practice and worse doctor well-being. These findings have implications for the well-being and retention of doctors as well as the quality of patient care, and may help to inform the content of future interventions aimed at preventing burnout and improving patient safety.
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Content ArticleThere are a number of fundamental weaknesses in governance around patient safety and the quality of care at Cwm Taf Morgannwg University Health Board, a joint review by Healthcare Inspectorate Wales (HIW) and the Wales Audit Office found. Following well-publicised concerns about maternity services at the Health Board, the joint review examined the organisation’s overall approach to quality governance. It found that whilst there has been a strong focus on financial balance and meeting key targets, less attention has been paid to the overall quality and safety of its services. The report highlights the need for stronger and broader leadership in respect of quality and patient safety and worryingly, points to a culture of fear and blame in some parts of the organisation that has prevented staff from speaking out and raising concerns.