Stage 2: Measuring performance

Ashmore, Stephen; Ruthven, Tracy; Hazelwood, Louise

doi:10.4324/9781003155393-3

Cited by 2 publications

(12 citation statements)

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“…Generally, percentages were sufficient to identify differences; however, probability values and odds-ratios with confidence intervals were used where appropriate for comparisons with NDHB or COMCORD data. Tables and graphs have been used for displaying findings (Ashmore et al, 2011b;Posavac & Carey, 2007). Inductive reasoning and explanatory data analysis looked for patterns and relationships within the data available, particularly in looking for factors that may be of influence on outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Reliability in this project is based on acceptance that the data found in the clinical records was accurate and truthful (Morse & Field, 1995), although it was limited by what data had been recorded (Ashmore et al, 2011b). Data were taken directly and verbatim from clinical notes and recorded on the data collection tool.…”

Section: Demonstrating Reliability and Validitymentioning

confidence: 99%

“…Reliability was supported by only having one person collecting and coding the data and applying consistent measurements (Ashmore et al, 2011b;Bui, 2009). Being aware of the possible issues inherent in documentation can also assist in protecting the reliability of the findings (Babbie, 2008).…”

Section: Demonstrating Reliability and Validitymentioning

confidence: 99%

“…Face validity is the measure of whether the outcomes feel right or appear correct, and was supported by asking an expert, (in this case an NDHB Quality midwife), to review any questions that arose from the data itself (Ashmore et al, 2011b;Bryman, 2016). Externally, there were no events which could have affected outcomes, such as taking a sample from winter months only, and the data collected was from a snapshot in time which does not risk participants aging or leaving the area partway through labour.…”

Section: Demonstrating Reliability and Validitymentioning

confidence: 99%

“…Externally, there were no events which could have affected outcomes, such as taking a sample from winter months only, and the data collected was from a snapshot in time which does not risk participants aging or leaving the area partway through labour. There was no scope for the Hawthorne effect, where for example, midwives or women were aware of the proposed project and altered their behaviour, as the project was not advertised and data were collected retrospectively (Ashmore et al, 2011b;Babbie, 2008;Mertens & Wilson, 2012).…”

Section: Demonstrating Reliability and Validitymentioning

confidence: 99%

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Management of Prelabour Rupture of Membranes at Term, at Northland District Health Board.

Hay¹

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<p>Background Prelabour rupture of membranes at term (PROM) is a subject of interest to women and maternity care providers alike. Management of PROM varies internationally, and regionally within New Zealand, despite the presence of interprofessional consensus statements. Northland District Health Board (NDHB) policy differs from most maternity care facilities by enabling expectant management of labour for women at low risk of transmission of Group β Streptococcus to their baby to extend to 96 hours from time of rupture of membranes. This study aimed to explore whether the NDHB policy was applied in practice and safely served the needs of women and babies in this DHB. Methods A retrospective quantitative clinical notes review was conducted of files in a one-year sample. The clinical notes of 123 women who had duration from ROM to birth at term of 18 hours or more were reviewed. Statistical comparisons using percentages, means and odds-ratios were made to a one-year sample of all other births at term at NDHB facilities, and with birth data from the New Zealand College of Midwives Clinical Outcomes Research Database (COMCORD). Findings Variables including demographic data, antenatal and intrapartum care given, time factors and outcomes themselves were reviewed. Few variables impacted outcomes within the PROM sample, though use of intravenous oxytocin was associated with increased epidural use and increased incidence of instrumental birth. Wāhine Māori had an increased incidence of vaginal births but some variables and outcomes highlighted inequities, including reduced antenatal screening, a higher incidence of maternal smoking, severe postpartum haemorrhage, and admission to Special Care Baby Units. Duration splits at 48 and 96 hours were applied to identify whether time increased risks for women or babies, but duration did not appear to be a factor which increased risk. The phenomenon of PROM itself increased risk for women and babies, increasing rates of labour induction, augmentation, epidural use, operative births, postpartum haemorrhage, admission to Special Care Baby Units and decreased exclusive breastfeeding at discharge. Conclusions The NDHB PROM policy appeared to be applied consistently and did not appear to increase risk for women and babies. Risks were increased for all women with PROM, with some inequitable outcomes for wahine Māori and pēpi. This research provides a comparison which is informative for clinical practice, education, and future research, and supports women’s involvement in decision-making.</p>

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Section: Discussionmentioning

confidence: 99%

Section: Demonstrating Reliability and Validitymentioning

confidence: 99%

Section: Demonstrating Reliability and Validitymentioning

confidence: 99%

Section: Demonstrating Reliability and Validitymentioning

confidence: 99%

Section: Demonstrating Reliability and Validitymentioning

confidence: 99%

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