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A review of the first edition of The Obstetric Guidelines 2011-13
Dr Adil Todiwala (FY1)Miss Radha Indusekhar (Consultant)
Sarah Carnwell (Network Administrator)
IntroductionEvidenced-based medicine is rapidly becoming
more embedded in the practice of clinical medicine.
Clinical guidelines are quickly emerging in almost all wards and clinical environments, and the familiarity and dependency of them are growing.
The first edition of The Bedside Clinical Guidelines Partnership: Obstetric Guidelines has been published in February 2011.
It was compiled as an aide-memoir for all staff concerned with obstetric management, with the aim of standardising patient care.
Dudley Group of Hospitals NHS TrustMid Staffordshire General Hospital NHS
TrustThe Royal Wolverhampton Hospitals NHS
TrustThe Shrewsbury and Telford Hospitals
NHS TrustUniversity Hospital of North StaffordshireWalsall Hospitals NHS Trust
Aims & Objectives
Determine if the guidelines meet with the requirements of the obstetric staff.
Determine the awareness and usage of these guidelines amongst the obstetric staff.
Assess the usefulness and ease of the guidelines.
Evaluate the guidelines in a way which can help direct the development of further editions.
MethodsData collection: by questionnaire.
Members of obstetric staff included:Doctors (Consultants, Specialist Registrars,
SHO, FY1/2)MidwivesAdvanced Nurse PractitionersOthers (Medical Student, Student Midwife)
MethodsCentres included:
University Hospital of North StaffordshireShrewsbury and TelfordWalsall ManorMid Staffordshire GeneralRoyal WolverhamptonDudley Group Hospitals
Data Collection8
11
42
31
3 1
Consultant Specialist Registrar SHO FY1 Midwife
Student Midwife Medical Student
Consultant 8
Specialist Registrar 11
SHO 4
FY1 2
Midwife 31
Student Midwife 3
Medical Student 1
University Hospital of North Staffordshire 40
Mid Staffordshire General Hospital 0
Royal Wolverhampton Hospital 5Shrewsbury and Telford 2Dudley Group of Hospitals 0Walsall Manor Hospital 12Other (Keele University) 1
Medical Staff 25
Nursing Staff 31
Other 4
Are you aware of the Obstetric Guidelines?
Response Medical Staff(n=25)
Nursing Staff(n=31)
Other(n=4)
Total (%)(n=60)
Yes 25 28 2 55 (92%)
No - 3 2 5 (8%)
100 90
50
Have you seen a copy of the Obstetric Guidelines?
Response Medical Staff(n=25)
Nursing Staff(n=31)
Other(n=4)
Total (%)(n=60)
Yes 25 25 1 51 (85%)
No - 6 3 9 (15%)
100 80
25
In what form have you seen a copy of the Obstetric Guidelines?
Response Medical Staff(n=34)
Nursing Staff(n=31)
Other(n=1)
Total (%)(n=66)
A5 pocket book 25 22 1 48 (73%)
Copy on intranet 9 9 - 18 (27%)
Other - - - -
74
26 29
70
100
Do you have your own copy of the guidelines?
Response Medical Staff(n=25)
Nursing Staff(n=31)
Other(n=1)
Total (%)(n=57)
Yes 21 9 - 30 (53%)
No 4 22 1 27 (47%)
84
29
Who provided you with a copy of the guidelines?
Came in post 1
Clinical Risk Manager 1
College Tutor 3
Guideline Lead at UHNS 1
Lynne Lovekin, Rota Co-ordinator at UHNS 11
Maternity Unit, Shrewsbury 1
Network 2
Trudie Roberts 1
Trust 3
When at work, do you keep your copy of the guidelines with you?
Response Medical Staff(n=21)
Nursing Staff(n=9)
Other(n=0)
Total (%)(n=30)
Yes, all the time 5 4 - 9 (30%)Yes, some of the time 11 3 - 14 (47%)
No, never 5 2 - 7 (23%)
24
52
24 22
33
44
How often do you refer to the guidelines?
Response Medical Staff(n=25)
Nursing Staff(n=27)
Other(n=1)
Total (%)(n=53)
Daily - 2 1 3 (6%)Once a week 8 6 - 14 (26%)Once a month 13 14 - 27 (51%)Never 4 5 - 9 (17%)
16
52
32
19
52
22
7
100
How easy / difficult do you find the guidelines to use?
Response Medical Staff(n=25)
Nursing Staff(n=25)
Other(n=1)
Total (%)(n=51)
Very easy 1 7 - 8 (16%)Easy 24 15 1 40 (78%)Difficult - 3 - 3 (6%)Very difficult - - - -
96
4
60
28
12
100
How easy / difficult do you find the index to use to find the information you require in the guidelines?
Response Medical Staff(n=25)
Nursing Staff(n=24)
Other(n=1)
Total (%)(n=50)
Very easy 4 4 - 8 (16%)Easy 20 17 1 38 (76%)Difficult 1 3 - 4 (8%)Very difficult - - - -
4
80
16
13
71
17
100
What do you think about the quantity of information in the guidelines?
Response Medical Staff(n=25)
Nursing Staff(n=24)
Other(n=1)
Total (%)(n=50)
Too detailed - 3 - 3 (6%)Right amount of detail 23 20 1 44 (88%)Not enough detail 2 1 - 3 (6%)
92 83 100
13
How easy / difficult to follow do you find the text in the guidelines?
Response Medical Staff(n=25)
Nursing Staff(n=24)
Other(n=1)
Total (%)(n=50)
Very easy 2 3 - 5 (10%)Easy 21 18 1 40 (80%)Difficult 2 3 - 5 (10%)Very difficult - - - -
84 75 100
8
8
13
13
How clear / difficult to follow do you find the diagrams in the guidelines?
Response Medical Staff(n=25)
Nursing Staff(n=24)
Other(n=1)
Total (%)(n=50)
Very easy 2 3 - 5 (10%)Easy 23 18 1 42 (84%)Difficult - 3 - 5 (6%)Very difficult - - - -
92
8
75
13
13
100
In which format would you prefer the guidelines to be available in?
Response Medical Staff(n=28)
Nursing Staff(n=32)
Other(n=1)
Total (%)(n=61)
A5 pocket book 14 18 1 33 (54%)A4 folder in clinical area 1 6 - 7 (11%)
Copy on intranet 7 5 - 12 (20%)All formats 6 3 - 9 (15%)Other - - - -
21
25
4
50
9
16
19
56
100
Conclusions
92% are aware of the Obstetric guidelines
85% have seen a copy of the Obstetric guidelines 73% A5 pocket book, 27% copy on the intranet
84% of medical staff own a copy of the guidelines, compared to 29% of nursing staff
30% keep their copy with them at all times, compared to 47% some of the time
88% felt the guidelines contained the right amount of detail
76% found the index easy to use
80% found the text easy to follow
84% found the diagrams easy to follow
78% found the guidelines as a whole easy to use
Conclusions
51% refer to the guidelines once a month, compared to 26% once a week, and 6% daily
All members of staff preferred the A5 pocket book (54% total)
However more nursing staff (19%) preferred to have the guidelines as an A4 folder, compared to medical staff (4%)
Conclusions
Improved feedback from Mid Staffordshire General Hospital and Dudley Group of Hospitals
Reasons why some trusts use the guidelines more than others
Promotion and increased awareness in trusts
More numbers, greater feedback
Conclusions
Action PlanAction Co-ordinator Action to be completed by
The results and comments of the audit will be used in the development of the next edition of the Obstetric Guidelines
Obstetric Guideline Group Feb 2012
The results and comments will be used to influence any future decision as to how the guidelines will be distributed within the Network
Obstetric Guideline Group Feb 2012
Allow increased accessibility of the A5 pocket book to nursing staff
Obstetric Guideline Group Feb 2012
The possibility of producing an A4 version of the guidelines will be discussed
Obstetric Guideline Group Feb 2012
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