Developing a real-time assessment of staffing needs in delivery suites

Ball, Jean A.; Washbrook, Marie

doi:10.12968/bjom.2010.18.12.780

Cited by 6 publications

(10 citation statements)

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“…Expedited birth may therefore cause considerable but unmeasured harm in many, for the benefit of few. Expedited birth also limits choice and, by creating additional workload, 38 may create risk 47 . Our third primary outcome, therefore, assessed expedited birth, either by induction of labour or pre‐labour caesarean section.…”

Section: Discussionmentioning

confidence: 99%

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The impact of a universal late third‐trimester scan for fetal growth restriction on perinatal outcomes in term singleton births: A prospective cohort study

Aderoba

Ioannou

Kurinczuk

et al. 2023

BJOG

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Objective To investigate perinatal mortality, morbidity and obstetric intervention following the introduction of a universal late third‐trimester ultrasound scan for growth restriction. Design Prospective cohort study. Setting Oxfordshire (OUH), UK. Population Women with a non‐anomalous singleton pregnancy undergoing pregnancy care and term delivery at OUH with an estimated due date (EDD) of birth between 1 January 2014 and 30 September 2019. Methods Universal ultrasound for fetal growth restriction between 35+0 and 36+6 weeks was introduced in 2016. The outcomes of the next 18 631 eligible term pregnancies were compared, adjusting for covariates and time, with the previous 18 636 who had clinically indicated ultrasounds only. ‘Screen‐positives’ for growth restriction were managed according to a pre‐determined protocol which included non‐intervention for some small‐for‐gestational‐age babies. Main Outcome Measures Extended perinatal mortality, a composite of mortality or encephalopathy Grade II–III, and expedited birth. Other outcomes included composite adverse outcomes used elsewhere, detection of low birthweight and birth from 37+0 to 38+6 weeks. Results Extended perinatal deaths decreased 27% and severe morbidity decreased 33% but neither change was statistically significant (adjusted odd ratio [aOR] 0.53, 95% confidence interval [C1] 00.18–1.56 and aOR 0.71, 95% CI 0.31–1.63). Expedited births changed from 35.2% to 37.7% (aOR 0.99, 95% CI 0.92–1.06). Birthweight (<10th centile) detection using fetal biometry alone was 31.4% and rose to 40.5% if all abnormal scan parameters were used. Conclusion Improvements in mortality and severe morbidity subsequent to introducing a universal ultrasound for growth restriction are encouraging but remain unclear. Little change in intervention is possible. The antenatal detection of low birthweight remains poor but improves where markers of growth restriction are used.

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Section: Discussionmentioning

confidence: 99%

“…Expedited birth also limits choice and, by creating additional workload, 38 may create risk. 47 Our third primary outcome, therefore, assessed expedited birth, either by induction of labour or pre-labour caesarean section. This rose 7.1%, from 35.2% to 37.7%.…”

Section: Rates Of Interventionsmentioning

confidence: 99%

The impact of a universal late third‐trimester scan for fetal growth restriction on perinatal outcomes in term singleton births: A prospective cohort study

Aderoba

Ioannou

Kurinczuk

et al. 2023

BJOG

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“…It is challenging to manage labour and delivery rooms workload with the necessary numbers and skills of midwives to meet agreed care standards. 17 Women should have one-to-one midwifery care when in established labour. 18 Safe midwifery staffing levels is a priority area for any maternity service.…”

Section: Midwifery Workforcementioning

confidence: 99%

Report on the Midwifery Workforce in the MOH, Saudi Arabia, for 2019

Altaweli¹,

Shaban²,

Paine³

2020

TPM

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This report presents the findings of a quantitative midwifery workforce study in the Ministry of Health (MOH) in Saudi Arabia in 2019. The aim of this report is to present the current midwifery workforce and recommend an adequate number of midwives required in maternity services based on a midwife-to-birth ratio. The midwifery workforce information in this report highlights a number of concerns related to the shortage of midwives and the lack of midwifery educational programmes within Saudi Arabia. It is difficult to form a national picture with the current published data because of a lack of relevant information.

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“…The developers have published a number of papers outlining current methods and its application in maternity settings, but details of the tools' development and underpinning assumptions are sparse. [1] [14] [18][19][20] They report that formulas have been updated and extended over time as the methodology has developed [14], but such changes remain unpublished. A version of the tool has been developed to monitor fluctuations in workload and midwife availability in real time via an App.…”

Section: Introductionmentioning

confidence: 99%

“…A version of the tool has been developed to monitor fluctuations in workload and midwife availability in real time via an App. [19] In 2014, The National Institute for Health and Care Excellence endorsed Birthrate Plus as a tool includes most of factors highlighted their safe staffing guideline[21], however they also made clear that this endorsement was not based on a judgement about the quality of the tool, a direct assessment of evidence or tests of the decision algorithms within it. [22] The Ockenden report into care failings in one UK maternity service [8] called for the feasibility and accuracy of the Birthrate Plus tool to be evaluated.…”

Section: Introductionmentioning

confidence: 99%

Evidence on the use of Birthrate Plus® to guide safe staffing in maternity services – a systematic scoping review

Griffiths,

Turner,

Lown

et al. 2023

Preprint

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Background : Birthrate Plus® is a widely used tool that informs decisions about the number of midwifery staff needed to provide safe and high quality care in maternity services. Evidence about the effectiveness, validity, reliability, and feasibility of tools such as this is needed. Objective : To identify, describe and analyse the available evidence supporting the use of Birthrate Plus. Methods: We searched PubMed, Medline, CINAHL, Google Scholar, Scopus, Academic Search, British Library Ethos, Directory of Open Access Journals and Science Direct. Studies were eligible if they reported empirical data relevant to the validity, reliability, or useability of Birthrate Plus or if they measured the impact on staffing levels, outcomes, costs or provided a comparison with other methods. Results: 23 sources of evidence were identified and reviewed. We found no prospective intervention studies on the use of Birthrate Plus to demonstrate outcomes for mothers, babies or staff wellbeing. Nor did we find studies comparing the tool to other methods or addressing resource use. Most of the evidence was descriptive, focussing on the use of the tool or the results of Birthrate Plus assessments. There is some evidence of the reliability of application of categories within the tool, the ability of the tool to detect variation in demand and to highlight staff shortages. Conclusions: In terms of traditional hierarchies of evidence, the evidence for Birthrate Plus is weak. There is a need for more independent research or simulation using real world data to understand how the tool performs in the current context of midwifery practice.

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Developing a real-time assessment of staffing needs in delivery suites

Cited by 6 publications

References 0 publications

The impact of a universal late third‐trimester scan for fetal growth restriction on perinatal outcomes in term singleton births: A prospective cohort study

The impact of a universal late third‐trimester scan for fetal growth restriction on perinatal outcomes in term singleton births: A prospective cohort study

Report on the Midwifery Workforce in the MOH, Saudi Arabia, for 2019

Evidence on the use of Birthrate Plus® to guide safe staffing in maternity services – a systematic scoping review

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