Experiences and outcomes of women with bleeding in early pregnancy presenting to the Emergency Department: An integrative review

Trostian, Baylie; Curtis, Kate; McCloughen, Andrea; Shepherd, Ben; Munroe, Belinda; Davis, Warren S.; Hirst, Elizabeth; Tracy, Sally

doi:10.1016/j.auec.2021.04.006

Cited by 4 publications

(5 citation statements)

References 49 publications

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“…Women in Australia have described dissatisfaction with general EDs, which are chaotic environments with busy staff who may lack the skills or resources to provide appropriate emotional support and adequate follow-up services. 16,17 This experience is also reflected in international literature. 18 Early pregnancy assessment unit or service models have become more popular in recent years as some countries attempt to improve acute early pregnancy care provision for women and families, divert care away from general ED settings, reduce hospital admissions for early pregnancy concerns, and provide more appropriate follow-up.…”

Section: Introductionmentioning

confidence: 78%

“…Midwives and registered nurses will be included in the review, as it is professionally recognized that, in many settings, registered nurses are often the identified providers of acute pregnancy care before 20 weeks' gestation. 2,17,19 Medical doctors, sonographers, student midwives, student nurses, enrolled nurses, Indigenous health workers, and assistants in nursing will not be included, as the role and scope of practice of these health professionals is not the focus of this review.…”

Section: Inclusion Criteria Participantsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Midwives’ and registered nurses’ role and scope of practice in acute early pregnancy care services in Australia: a scoping review protocol

Freeman

Bradfield

Cheney

et al. 2023

JBI Evidence Synthesis

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Objective: The objective of this review is to review and synthesize what is documented on the role and scope of practice of midwives and registered nurses working in acute early pregnancy care settings in Australia. Introduction: Women experiencing complications before 20 weeks of pregnancy may need to attend an acute care service, often a hospital emergency department. Midwives and registered nurses provide care for women with early pregnancy complications, and it is important that their role and scope of practice is documented. This review will explore the literature relating to acute early pregnancy care in Australia to better understand how midwives’ and registered nurses’ roles and scope are currently described in this setting. Inclusion criteria: Any literature that explores the role and scope of practice of midwives and registered nurses who care for women who present to acute care services in Australia with early pregnancy complications will be considered for inclusion in the review. Methods: A 3-step review process will involve a preliminary search of MEDLINE and ProQuest, followed by a more detailed search of a larger selection of databases, using identified keywords and phrases from the initial search. Reference lists of retrieved literature will then be examined for relevant citations. Literature in English will be considered, including relevant gray literature. Search results will be imported into reference and review support software. Data that align with the inclusion criteria will be organized into tabulated and narrative formats for presentation. Details of this review project are available at: Open Science Framework https://osf.io/5bnqz

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Section: Introductionmentioning

confidence: 78%

Section: Inclusion Criteria Participantsmentioning

confidence: 99%

See 1 more Smart Citation

Midwives’ and registered nurses’ role and scope of practice in acute early pregnancy care services in Australia: a scoping review protocol

Freeman

Bradfield

Cheney

et al. 2023

JBI Evidence Synthesis

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“…[4][5][6] Specialised early pregnancy services have shown to improve patient and health service outcomes, including reduced ED length of stay (EDLOS), representations and cost; however, equitable access is limited. 7 There is limited evidence describing ED presentation trends and outcomes across a health district with varied access to early pregnancy services and differing models of ED care and resource availability. A multicentre approach facilitates comparison and provides insight into how health service outcomes are impacted by ED presentation trends and patient characteristics.…”

Section: Introductionmentioning

confidence: 99%

“…Within the ED, specialised services would include nurse practitioners (NP) or clinical midwifery consultants 4–6 . Specialised early pregnancy services have shown to improve patient and health service outcomes, including reduced ED length of stay (EDLOS), representations and cost; however, equitable access is limited 7 …”

Section: Introductionmentioning

confidence: 99%

Presentation trends, characteristics and outcomes for women with early pregnancy bleeding in the emergency department: A 10‐year data linkage study

Trostian

McCloughen

Fethney

et al. 2023

Aust NZ J Obst Gynaeco

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BackgroundWomen present to the emergency department (ED) with pregnancy complications including bleeding. They seek investigations, treatment and clear discharge and referral pathways.AimsThe aim was to identify trends, characteristics, ED care and discharge pathways for women who present to the ED with early pregnancy bleeding.MethodsRetrospective data (from 2011 to 2020) were extracted from a regional health district‘s databank. Data were processed, and deterministic linking was used to produce a final data set. Descriptive statistics were used to identify trends and characteristics. Linear and logistic regression models were used to identify factors that influence health service use, outcomes and discharge pathways.ResultsOver the 10 years, there have been almost 15 000 presentations to the ED for early pregnancy bleeding, from approximately 10 000 women, 0.97% of all ED presentations. The frequency of presentations increased by 19.6% over the study period. The average age of women who presented to the ED was 29.1 years, which increased from 28.5 years (2011) to 29.3 (2020). The median length of stay was less than 4 h, and most women were treated and discharged from the ED. One‐third of presentations received neither ultrasound nor pathology, but health service costs increased by 330% from 2014 to 2020.ConclusionsMaternal age is increasing, as is the frequency of ED presentations for early pregnancy bleeding, and both factors increase demands on the ED. Findings from this study may inform strategies to improve current care models and improve quality and safety practices within the ED.

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Midwives’ and registered nurses’ role and scope of practice in acute early pregnancy care settings in Australia: A qualitative descriptive study

Freeman,

Moroney,

Warland

et al. 2024

Women and Birth

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Experiences and outcomes of women with bleeding in early pregnancy presenting to the Emergency Department: An integrative review

Cited by 4 publications

References 49 publications

Midwives’ and registered nurses’ role and scope of practice in acute early pregnancy care services in Australia: a scoping review protocol

Midwives’ and registered nurses’ role and scope of practice in acute early pregnancy care services in Australia: a scoping review protocol

Presentation trends, characteristics and outcomes for women with early pregnancy bleeding in the emergency department: A 10‐year data linkage study

Midwives’ and registered nurses’ role and scope of practice in acute early pregnancy care settings in Australia: A qualitative descriptive study

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