Knowledge levels of midwives regarding the interpretation of cardiotocographs at labour units in KwaZulu-Natal public hospitals

Abstract

BackgroundThe primary purpose of cardiotocography is to detect early signs of intrapartum hypoxia and improve foetal outcomes. Intrapartum hypoxia remains the major cause of perinatal deaths during monitored labours. This is attributed to the midwives’ lack of knowledge and skills in the foetal implementation and interpretation of cardiotocographs.ObjectivesThis study aimed to establish midwives’ knowledge and interpretive skills of cardiotocography.MethodThe study employed a quantitative research approach with an explorative, descriptive, cross-sectional design. A total of 226 purposively selected participants were asked to complete a self-administered, structured questionnaire, of which 125 responded by completing the questionnaire. The study was conducted in labour wards in KwaZulu-Natal public hospitals in 2014. Data analysis was performed by means of descriptive and inferential statistics using analysis of variance.ResultsThe findings revealed that the midwives in KwaZulu-Natal public hospitals were found to be clinically lacking in knowledge of cardiotocography.ConclusionThe limited cardiotocographic knowledge of the midwives in KwaZulu-Natal public hospitals was possibly because of a lack of in-service training, as more than half of the participants (70%) indicated a need for this.

Formal training in cardiotocograph interpretation of healthcare practitioners improves interpretation: A prospective descriptive analytical study in a resource constrained setting

“…This most likely reflects the lack of properly structured, regular CTG training programs. In contrast to our own and other international findings, 15,16 a local study reported no difference in HCWs’ knowledge when correlated to in service training 17 . We believe the type and interval of training is the reason for these different findings.…”

“…The need for training in this population is reflected by the participants’ poor baseline knowledge, perceived inadequacy of pre‐graduate training, and expressed desire for training. Similar findings were echoed by other local studies 17,18 …”

“…Similar findings were echoed by other local studies. 17,18 Our study highlighted that training strategies varied among HCWs, even within the same group. This most likely reflects the lack of properly structured, regular CTG training programs.…”

“…In contrast to our own and other international findings, 15,16 a local study reported no difference in HCWs' knowledge when correlated to in service training. 17 We believe the type and interval of training is the reason for these different findings. Beckley et al 20 had similar findings in their study in 2000.…”

“…Most registered midwives practice in clinics and district hospitals where they primarily provide midwife‐led obstetric care without senior assistance immediately available. Considering their poor baseline knowledge, poor confidence levels, and their perception of inadequate pre‐graduate training, a high number of intrapartum related hypoxic events from clinics and district hospitals is expected 17,18,21 . This is further compounded by the fact that most are not currently receiving continuous CTG training and only a minority felt that the training they do receive equips them to perform their clinical role.…”