Imminent birth education program

Australian Journal of Rural Health, 2019

In 2016, 97% of mothers gave birth in hospitals with smaller numbers of women birthing in other settings including birth centres, home or before arrival to hospital. The closure of small maternity services in rural and remote Australia 2 and internationally has occurred over the past two decades. These closures have resulted in some women needing to travel vast distances to birth in hospitals with a maternity service. It is inevitable that some women will present in established

Journal of Obstetric, Gynecologic & Neonatal Nursing, 2013

The Journal of Perinatal Education, 2012

In this column, the editor of The Journal of Perinatal Education discusses the Institute of Medicine’s 2011 report, The Future of Nursing: Leading Change, Advancing Health, and its implications for childbirth educators. The editor also describes the contents of this issue, which offer a broad range of resources, research, and inspiration for childbirth educators in their efforts to promote, support, and protect natural, safe, and healthy birth.

Australian Health Review, 2013

The aim of this study was to determine whether the NSW Inpatient Statistics Collection (ISC), a census of hospital admissions, could be used to estimate the magnitude of, and reasons for, antenatal transfer of rural women. Data from the ISC were compared with results of a clinical audit of all antenatal admissions of rural women to perinatal centres in NSW during 1997NSW during -1998. While the overall number of perinatal centre admissions identified by the ISC and the audit were similar, the ISC identified only about 70% of antenatal transfers. Rural hospitals identified 12% of women as indigenous compared with 9% at perinatal centres. The ISC showed 28% of rural women admissions and 42% of transfers were for threatened preterm labour compared with 21% and 30% respectively from the audit.

2020

Background Primary maternity units (PMUs) offer less expensive and potentially more sustainable maternity care, with comparable or better perinatal outcomes for normal pregnancy and birth than higherlevel units. However, little is known about how these maternity services operate in rural and remote Australia, in regards to location, models of care, service structure, support mechanisms or sustainability. This study aimed to confirm and describe how they operate. Design A descriptive, cross-sectional study was undertaken, utilising a 35-item survey to explore current provision of maternity care in rural and remote PMUs across Australia. Data were subjected to simple descriptive statistics and thematic analysis for free text answers. Setting and Participants: Only 17 PMUs were identified in rural and remote areas of Australia. All 17 completed the survey. Results The PMUs were, on average, 56km or 49 minutes from their referral service and provided care to an average of 59 birthing women per year. Periodic closures or downgrading of services was common. Low-risk eligibility criteria were universally used, but with some variability. Medically-led care was the most widely available model of care. In most PMUs midwives worked shift work involving both nursing and midwifery duties, with minimal uptake of recent midwifery workforce innovations. Perceived enablers of, and threats to, sustainability were reported. Key Conclusions and Implications for Practice A small number of PMUs operate in rural Australia, and none in remote areas. Continuing overreliance on local medical support, and under-utilisation of the midwifery workforce constrain the restoration of maternity services to rural and remote Australia.

Australian and New Zealand Journal of Obstetrics and Gynaecology, 2017

Background: Obstetric emergency simulation training is an evidence-based intervention for the reduction of perinatal and maternal morbidity. In Western Australia, obstetric emergency training has been run using the In Time course since 2006. Aims: The study aimed to determine if the provision of In Time train the trainer courses to outer metro, rural and remote units in Western Australia had led to sustained ongoing training in those units. Ten years following the introduction of the course, we performed a survey to examine which units are continuing to run In Time, what are the perceived benefits in units still utilising In Time, and what were the barriers to training in units that had discontinued. Materials and methods: A link to an online survey was sent to the units where In Time training had occurred. Telephone enquiries were additionally used to ensure a good response rate. Results: The survey response rate was 100%. Six of the 11 units where training had been provided continue to run In Time. Units where training had discontinued had done so in order to take up alternatives, or as a result of trainers leaving. Of the units who had discontinued training, one wished to recommence In Time. Conclusions: Local in situ training in obstetric emergencies as exemplified by the In Time course remains a popular and valued training intervention across Western Australia. This training may be of particular benefit to small and remote units, but these are the areas in which training is hardest to sustain. K E Y W O R D S patient safety, rural and remote, simulation, training Remote 760-840 On call after hours 4 Rural 430-490 On call after hours 5 Rural 820-1020 On call after hours 6 Rural 480-600 On call after hours 7 Rural 260-350 On call after hours 8 Outer metro 1300-1800 On call after hours 9 Outer metro 770-960 On call after hours

Best practice & research. Clinical obstetrics & gynaecology, 2015

An estimated 289,000 maternal deaths, 2.6 million stillbirths and 2.4 million newborn deaths occur globally each year, with the majority occurring around the time of childbirth. The medical and surgical interventions to prevent this loss of life are known, and most maternal and newborn deaths are in principle preventable. There is a need to build the capacity of health-care providers to recognize and manage complications during pregnancy, childbirth and the post-partum period. Skills-and-drills competency-based training in skilled birth attendance, emergency obstetric care and early newborn care (EmONC) is an approach that is successful in improving knowledge and skills. There is emerging evidence of this resulting in improved availability and quality of care. To evaluate the effectiveness of EmONC training, operational research using an adapted Kirkpatrick framework and a theory of change approach is needed. The Making It Happen programme is an example of this.

MedEdPublish, 2019

This paper describes the experience of planning and presentation of a short human factors training intervention aimed at staff working in maternity services, in light of some challenging conclusions about negative outcomes of existing maternity provision. A local initiative, initiated and supported by Health Education England (HEE) and involving 3 trusts in the north west of England, was aimed at providing appropriate training for senior practitioners. While many participants claimed knowledge of and confidence in Human Factors (HF) issues, the course was well received and ongoing training needs were identified, if only for their junior colleagues. The paper explores plans for a Phase 2 programme which is designed to roll out the training to those junior staff and to begin the process of gathering data from observation of practice on a day to day basis. Data from this activity will inform a plan for Phase 3 when issues of shop floor culture will be subject to productive intervention.

Australian and New Zealand Journal of Obstetrics and Gynaecology, 2010

Background: The Fetal Welfare Obstetric emergency Neonatal resuscitation Training (FONT) project was initiated on a background of rising notifications of adverse events in NSW maternity units, the significant proportion of which were related to fetal welfare assessment. Aims: The aim of the study is to describe the development and introduction of the NSW statewide interprofessional FONT project. Methods: Following development and risk assessment, FONT was launched in February 2008. The project consists of an online component and two face-to-face training days to be completed each 3 years; the first day for fetal welfare assessment and the second for obstetric and newborn emergencies. Eight, 2-day training sessions were conducted throughout NSW for FONT trainers. Each trainer underwent pre-and post-testing for changes in knowledge of fetal welfare assessment. The 2005-2008 NSW adverse event report numbers were assessed. Results: From 20 February to 17 April 2008, 240 trainers had been trained in fetal welfare assessment, and by the end of 2008 these trainers had trained 954 clinicians. There were significant improvements in the interpretation and management planning of electronic fetal heart rate patterns following training. Analysis of Severity Assessment Codes 1 and 2 showed no significant trend in the number of notifications for adverse events related to fetal welfare assessment. Conclusions: In the first 11 months, 25% of the state's maternity practitioners had received training in the first stage of the FONT project. The FONT project has shown short-term improvements in learning and communication skills and in the participants of the project.