Elective Caesarean Section……improving the woman’s birth ... › media › 3277328 ›...
Transcript of Elective Caesarean Section……improving the woman’s birth ... › media › 3277328 ›...
Our clinical team recognised that women requiring elective LUSCS had limited choices surrounding their birth.
z The aim of this project is to enhance the birth experience of women undergoing elective caesarean section, ensuring the provision of safe, effective, person-centred care
Primary Drivers
• Enhance support for a close relationship between mother and baby and initiation of feeding as soon as possible after birth
• Improve the birth environment
• Reduce incidence of Surgical Site Infection (SSI)
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Secondary Driver • Improve information and preparation of women • Improve theatre etiquette with ALL staff • Implementation of theatre bundle (pre incision antibiotics,
wound preparation, preoperative catheterisation) • Use of surgical brief and theatre safety brief • Promotion of teamwork within the multidisciplinary team • Initial care of baby completed in theatre prior to transfer
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Project Processes
• Our clinical team recognised that women requiring elective caesarean section had limited choices surrounding their birth.
• The Quality Strategy (2010), The Refreshed Framework for Maternity Services (2011) and UNICEF Baby Friendly Initiative (2012) provided the basis for our focus on improving women’s birth experience.
• A collaborative approach was established with the multidisciplinary team.
• I engaged with women through face to face discussion. • Various reports were collated and reviewed e.g. SSI rates, theatre
audit, Clinical Quality Indicators. • I gathered relevant information from other sources such as • Gynaecology, Obstetric and Neonatal Effectiveness Committee
(GONEC), NICE Guidelines, SPSP, HPS and HIS. • A Driver Diagram was developed and used as the improvement tool. • A personal coach provided ongoing support and encouragement in self
development which confirmed that leadership comes from within.
Actions • Improved information leaflet • Earlier time of admission • Reduced fasting times • Women’s choice of music • Reduced unnecessary noise in theatre • Surgical safety brief • Hair clipping on table • Catheterisation by circulating staff • MW receiving baby scrubbed • Betadine left to dry for 3 minutes • Pre-incision antibiotics • Baby weighed and examined in front of
parents in theatre allowing immediate skin-to-skin in recovery
• Improved use of MEWS • Staff seconded to theatre for 4 month blocks • Anaesthetic nurses participate in pre op, intra
op and post op care Evaluation
• A staff discussion group showed that staff felt more satisfied, team work was improved, theatre ran more smoothly and roles were more defined
• SSI 4% in Aug 2012. 2% in Dec 12. • Women reported a positive birth experience
while having an elective caesarean section
Elective Caesarean Section……improving the woman’s birth journey at Royal Alexandra Hospital, Paisley Project Leader: Jacqueline Crawford