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Found 48 results
  1. Content Article
    The link below will take you to all of the associated resources on the THIS.institute website including: Video: Managing obstetric emergencies in women with suspected or confirmed COVID-19 COVID-19: Five key goals in managing an obstetric emergency Downloadable poster of the five key goals.
  2. Content Article
    The benefits of Continuity of Carer (CoC) within antenatal and postnatal care, and the implications for patient safety are well reported. As a midwife, to know the person from booking to postnatal means I am aware when their mental health may be deteriorating, or when they may be experiencing relationship difficulties. It also makes me feel more confident to challenge situations, including potential safeguarding concerns or welfare issues. If a person trusts in their relationship with their midwife, they are more likely to confide that they are struggling, and we'll be better placed to support their health needs. Supporting people within their wider context Community midwifery is not just caring for a person’s physical needs. It’s knowing their family, their housing situation, their past social history, understanding their vulnerabilities and hearing them when they tell us that something isn’t right – whether that be in relation to their pregnancy, their relationship or their mood. This is incredibly difficult to achieve without CoC and is frustrating for both midwives and pregnant people. Midwives want to offer excellent care and pregnant people deserve excellent care. I recently visited a family who were struggling financially. Although I was aware of their financial predicaments, I had no idea the extent of the issue. I went one afternoon for an antenatal visit. The atmosphere was very tense, and I had heard raised voices upon approaching the house. When I entered the house, their child was crying and shouting, and the parents were distressed. Because of the strength of the relationship we had developed during the pregnancy, I felt able to challenge the couple about what was happening and what I was experiencing with regard to the tension between them. I was informed they had no food and had to get through the weekend with nothing to eat. The mother had been too scared to tell anyone in case her children were taken away from her. This opened up a conversation about their welfare generally and we were able to work together, with other support services, to meet the immediate crisis and attempt to start dealing with the ongoing issues. Monitoring mental health Another person disclosed at booking some historical mental health issues. She had been fine for a few years and had not required treatment recently. During an appointment a few months later, I felt I wasn’t experiencing her like I usually did. It wasn’t anything obvious just a ‘sense’ that she was holding something back. I gently probed her, and she informed me she had been struggling with anxiety in relation to hypervigilance regarding the baby’s movements. We spent some time working on strategies to manage this anxiety and, aware of the clock ticking during a short antenatal appointment, I arranged to see her for a double appointment at my next clinic and referred her to the mental health midwife for ongoing support. In times of loss Something we rarely talk about as midwives is loss. Caring for a family from booking, to finding out the baby had died, to birth and beyond, taught me a lot about the power of CoC. Being present when the couple met their baby and supporting them for as long as they needed postnatally was an enormous privilege. Although challenging because of the depth of grief, knowing I could make a small difference to their experience, because I knew them and they trusted me, meant we were able to discuss very difficult decisions over a cup of tea whilst the other children ran around us bringing a level of normality to a very awful situation. Relationships matter I have received some amazing feedback from families regarding CoC. Recently a woman said that the strength of our relationship was important to her because she trusted my judgement and ability to advocate for her. She said her experience of CoC had made something that was terrifying to her “not so scary”. Thank you cards I have received always comment on the strength of the relationship. Over and above any other element of care a person has received during the pregnancy continuum, the relationship and the patient feeling like I ‘know’ them is what they reflect on when we are saying goodbye (which is the hardest part of this model of care!). As a midwife I get amazing job satisfaction from taking a family from booking to birth to discharge. The privilege of being present during such a life altering time in a family’s life whether it be a first baby or tenth baby, leaves a mark. Every family I look after leaves a footprint. If you'd like to share your thoughts on the Midwifery Continuity of Carer model, you can join the conversation here.
  3. News Article
    More than three-quarters of midwives think staffing levels in their NHS trust or board are unsafe, according to a survey by the Royal College of Midwives (RCM). The RCM said services were at breaking point, with 42% of midwives reporting that shifts were understaffed and a third saying there were “very significant gaps” in most shifts. Midwives were under enormous pressure and had been “pushed to the edge” by the failure of successive governments to invest in maternity services, said Gill Walton, the chief executive of the RCM. “Maternity staff are exhausted, they’re demoralised and some of them are looking for the door. For the safety of every pregnant woman and every baby, this cannot be allowed to continue,” she said. “Midwives and maternity support workers come into the profession to provide safe, high-quality care. The legacy of underfunding and underinvestment is robbing them of that – and worse still, it’s putting those women and families at risk.” RCM press release Read full story Source: The Guardian, 16 November 2020
  4. Content Article
    The aim of this framework, produced by the Royal College of Midwives, is to help Local Maternity Systems and the Maternity Transformation Programme to measure, consistently, the level of continuity of carer being provided over time, not only to monitor delivery, but also to help evaluate the extent to which particular models realise the benefits set out in evidence. This document summarises the policy expectations and then suggests a measurement framework that draws on existing data, or that can be incorporated into other existing data collection thus imposing minimal burden on health care organisations and staff. It provides clarity in terms of how continuity of carer is to be defined and measured, and benchmark data upon which improvement can be measured.
  5. Event
    until
    How can we better support nurses and midwives to flourish and thrive in their work? Join the King's Fund at this free online event to discuss the changes needed to empower nurses and midwives to shape and provide the compassionate, high-quality care that they aspire to in a sustainable way – through the COVID-19 pandemic and beyond. The conversation will explore: workplace stressors, work conditions and ways of working – including workload, shift patterns and supervision – that have an impact on nurse and midwife wellbeing, and how these can be positively transformed organisational cultures and leadership styles – including those around diversity and inclusion, psychological safety and compassionate leadership at all levels – that need to be cultivated, and how progress can be achieved lessons and examples of good practice from across the health and care system, from both before and during the COVID-19 pandemic. Register
  6. Community Post
    We should all strive to keep antibiotics working for our NHS surgeons and future generations, by decreasing antibiotic use in medicine. It is mums themselves who could dramatically decrease antibiotic use, in the only medical specialty where this is possible - in obstetrics - by keeping skin intact; by being informed of the 10cm diameter that 'Aniball' and 'Epi-no Delphine Plus' birth facilitating devices, the mechanical version of Antenatal Perineal Massage, achieve by skin expansion (much like by 'earlobe skin expanders') prior to birth, for back of baby's head. This enables a normal birth for many more babies by shortening birth, with no cutting (episiotomies) or tearing, and much fewer Caesarean sections, as each Caesarean section requires antibiotics to be injected into mum, to kill any bacteria, which might have invaded a skin cell, from being implanted with that skin cell, deep into the wall of the uterus, by the surgeon's knife. There are around 750,000 births in the UK alone and three-quarters of mums are damaged during birth and at risk of developing infection; so a dramatic decrease in antibiotic use is possible. Empowering mums with knowledge; that both the skin and the coats of the pelvic floor muscles, which form the floor of the lower tummy, can be stretched painlessly, in preparation of birth, from the 26th week of pregnancy, so a gentler, kinder birth for both baby and mum becomes possible by decreasing risky obstetric interventions. Muscle can be stretched to 3 times its original length, if stretched painlessly over 6 or more occasions, and still retains its ability to recoil back, contracting to its original length. So there is no damage to mum. Baby's delicate head is not used to achieve this 'birth canal widening', because Antenatal Perineal Massage or Aniball or Epi-no Delphine Plus have already achieved this prior to the start of birth. In birth this stretching is rushed within the last 2 hours of birth, with risk of avulsion of pelvic floor muscle fibres from the pubic bone and risk of skin tearing or the need for episiotomy. The overlying skin will likewise stretch without tearing if done over 6 or more occasions. The maximal opening in the outlet or lower part of the pelvis is 10cm diameter, so 10cm diameter is the goal of the birth aiding devices and 'Antenatal Perineal Massage' or 'Birth Canal Widening' - opening doors for baby maximally. The mother reviews on 'Aniball' and 'Epi-no Delphine Plus' are impressive: Wanda Klaman, a first time mum, gives birth at nearly 42 weeks to a 4.4kg baby, with no need for episiotomy or forceps; Sophie of London, avoids episiotomy, when forceps are used to aid delivery for her baby who lays across her tummy - transverse lay, because the skin at this opening is so stretchy thanks to the birth facilitating devices. Cochrane Collaborate Report on Antenatal Massage https://pubmed.ncbi.nlm.nih.gov/23633325/ https://www.dailymail.co.uk/news/article-7450045/Fears-infections-pandemic-grow-NINETEEN-new-superbugs-discovered-UK.html https://www.mirror.co.uk/news/uk-news/mistakes-maternity-wards-setting-nhs-22702909
  7. Content Article
    Key findings The Covid-19 pandemic has put the UK health and care workforce under unprecedented pressure. The workforce had been struggling to cope even before the pandemic took hold. Staff stress, absenteeism, turnover and intentions to quit had reached alarmingly high levels in 2019, with large numbers of nurse and midwife vacancies across the health and care system. And then the pandemic struck. The impact of the pandemic on the nursing and midwifery workforce has been unprecedented and will be felt for a long time to come. The crisis has also laid bare and exacerbated longstanding problems faced by nurses and midwives, including inequalities, inadequate working conditions and chronic excessive work pressures. The health and wellbeing of nurses and midwives are essential to the quality of care they can provide for people and communities, affecting their compassion, professionalism and effectiveness. This review investigated how to transform nurses’ and midwives’ workplaces so that they can thrive and flourish and are better able to provide the compassionate, high-quality care that they wish to offer. Nurse and midwives have three core work needs that must be met to ensure wellbeing and motivation at work, and to minimise workplace stress: autonomy, belonging and contribution. This report sets out eight key recommendations designed to meet these three core work needs. These recommendations focus on: authority, empowerment and influence; justice and fairness; work conditions and working schedules; teamworking; culture and leadership; workload; management and supervision; and learning, education and development.
  8. News Article
    An 'expanded workforce' will be delivering flu and a potential COVID-19 vaccine, under proposals unveiled by the Government today. The three-week consultation also focuses on a proposal of mass vaccinations against COVID-19 using a yet-to-be-licensed vaccine, if one becomes available this year. The Department of Health and Social Care (DHSC) is hoping new legislation could come into effect by October, ahead of the winter season. The consultation proposes to amend the Human Medicine Regulations 2012 to "expand the workforce legally allowed to administer vaccines under NHS and local authority occupational health schemes, so that additional healthcare professionals in the occupational health workforce will be able to administer vaccines". It said this would include 'midwives, nursing associates, operating department practitioners, paramedics, physiotherapists and pharmacists'. The consultation said: "This will help ensure we have the workforce needed to deliver a mass COVID-19 vaccination programme, in addition to delivery of an upscaled influenza programme, in the autumn." The consultation also said that "there is a possibility that both the flu vaccine and the COVID-19 vaccine will be delivered at the same time, and we need to make sure that in this scenario there is sufficient workforce to allow for this". Read full story Source: Pulse, 28 August 2020
  9. Content Article
    Unicef UK Baby Friendly Initiative has updated its policy guidance in the light of these investigations and some organisations are using posters and checklists to help staff understand and carry out their responsibilities. HSIB has also observed the impact of high task load, environment and staffing levels on the ability of staff to detect SUPC. Recommendations Maternity services should consider the following learning observations to ensure safe delivery of skin-to-skin care. • Based on the evidence, a baby who is born apparently well, with good Apgar scores, can be safely laid skin-to-skin with the mother or parent and requires close observation in the first minutes after birth. • Apgar scores must be attributed using close clinical observation of the baby. This can be achieved with the baby remaining in skin-toskin contact. There may be a need to interrupt skin-to-skin contact briefly to ensure Apgar scoring is assessed accurately. • Vigilant observation of the mother and baby should continue, with prompt removal of the baby if the health of either gives concern. • Mothers should be encouraged to be in a semirecumbent (half lying, half sitting) position to hold and feed their baby, ensuring the mother can see the baby’s face. • Care should be taken to ensure that the baby’s position is such that their airway remains clear and does not become obstructed. • Staff should have a conversation with the mother and her companion about recognising any changes in the baby’s condition. • Always listen to parents and respond immediately to any concerns raised. • Medicines given to the mother should be considered when discussing skin-to-skin contact. Pain relief given to mothers can affect their ability to observe and care for their baby. • Additional risk factors should also be considered. The level of risk for SUPC when a baby is in skin-to-skin contact can increase with, for example, increased maternal body mass index, antenatal use of opiate medication, sedation, and staff’s focus on other tasks.
  10. Content Article
    Episodes: Beginnings Apprentice Flying Solo Detour Balance Night Shift Motherhood Part 1 Motherhood Part 2 Continuity Homebirth Caesarean Flexible Mistakes Dads Guidelines Hands on Postnatal Handover MindNBody Lithotomy Teacher Language 1 Language 2 Names Ally Baby Loss Awareness Week Names Dates Big baby Statistics Click on the link below to access the full series.
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