Substandard care in delivery‐related asphyxia among term infants: prospective cohort study

Evers, Annemieke C.C.; Brouwers, H. A. A.; Nikkels, Peter G. J.; Boon, Janine; Egmond-Linden, Anneke van; Groenendaal, Floris; Hart, Claartje; Hillegersberg, Jacqueline; Snuif, Yvette S.; Sterken-Hooisma, Sietske; Bisschop, Charlotte N. Steins; Westerhuis, Michelle E.M.H.; Bruinse, Hein W.; Kwee, Anneke

doi:10.1111/aogs.12012

Cited by 10 publications

(8 citation statements)

References 29 publications

(23 reference statements)

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“…As a subjective process, authors acknowledge risk selection's complexity, determined by health care organisation, care providers and women [98]. Organisation characteristics include the number of care providers involved in care provision, location, communication, collaboration, and geography [30,58,69,93,[99][100][101][102][103][104][105][106][107][108][109][110][111][112][113]. Health care providers' perceived risk, knowledge, expertise, confidence, personal views, awareness and attitude, financial considerations and women's characteristics and preference, amongst others, are described as decisive factors [17][18][19]26,46,[86][87][88]95,99,100,105,107,109,[114][115][116][117][118].…”

Section: Risk Selection As a Practice: Detecting And Assessing Risk mentioning

confidence: 99%

“…Timing is considered a highly important feature of the detection, assessment and decision making process. Generally, risk selection is addressed in two ways; the time until risk detection [28,31,[137][138][139] and the time between risk detection and care provision [30,31,66,101,140,141]. It is emphasized that prolonged time between risk detection and care provision can cause delay, leading to preventable morbidity and mortality.…”

Section: Risk Selection As a Practice: Detecting And Assessing Risk mentioning

confidence: 99%

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Towards a better understanding of risk selection in maternal and newborn care: A systematic scoping review

et al. 2020

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Globally, millions of women and their children suffer due to preventable morbidity and mortality, associated with both underuse and overuse of maternal and newborn care. An effective system of risk selection that differentiates between what care should be provided and who should provide it is a global necessity to ensure women and children receive appropriate care, at the right place and the right time. Poor conceptualization of risk selection impedes evaluation and comparison of models of risk selection across various settings, which is necessary to improve maternal and newborn care. We conducted a scoping review to enhance the understanding of risk selection in maternal and newborn care. We included 210 papers, published over the past four decades, originating from 24 countries. Using inductive thematic analysis, we identified three main dimensions of risk selection: (1) risk selection as an organisational measure to optimally align women's and children's needs and resources, (2) risk selection as a practice to detect and assess risk and to make decisions about the delivery of care, and (3) risk selection as a tool to ensure safe care. We found that these three dimensions have three themes in common: risk selection (1) is viewed as both requiring and providing regulation, (2) has a provider centred focus and (3) aims to avoid underuse of care. Due to the methodological challenges of contextual diversity, the concept of risk selection needs clear indicators that capture the complexity of care to make crosssetting evaluation and comparison of risk selection possible. Moreover, a comprehensive understanding of risk selection needs to consider access disparity, women's needs, and unnecessary medicalization.

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Section: Risk Selection As a Practice: Detecting And Assessing Risk mentioning

confidence: 99%

Section: Risk Selection As a Practice: Detecting And Assessing Risk mentioning

confidence: 99%

Towards a better understanding of risk selection in maternal and newborn care: A systematic scoping review

et al. 2020

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“…The continuous use of EFM during labor of low risk women and poor EFM interpretation may lead to an increased Caesarean section rate without a signi cant reduction in cerebral palsy or infant mortality [2,6,7]. Errors in the interpretation of cardiotocography (CTG) traces and failure to identify and manage pathological tracings are recognized causes of adverse obstetric outcomes [8,9,10,11]. Additionally, cases of false interpretation and unsuitable management of cardiotocographic (CTG) traces may also lead to large nancial costs [12].…”

Section: Introductionmentioning

confidence: 99%

The development and psychometric evaluation of the Electronic Fetal Monitoring Knowledge Scale

Gourounti

Sarantaki

Diamanti

et al. 2020

Preprint

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Background. The aim of this study was to develop and assess the psychometric properties of the Electronic Fetal Monitoring Knowledge Scale (EFMKS), a self-report and short instrument measuring knowledge concerning Electronic Fetal Monitoring (EFM). Additionally, it was aimed to use the EFMKS for briefly assessing EFM knowledge in midwives and doctors working in labour ward. Methods. The EFMKS was developed in a three-phase process by using an integrated mixed-methods approach that included literature reviews, professional focus groups, expert consultations and a psychometric survey evaluation. The psychometric evaluation was conducted by recruiting a sample of 128 professionals (midwives and doctors). Data were collected between April and July of 2016 in two public hospitals of Athens, Greece. Content validity, exploratory factor analysis, discriminant and construct validity, test-retest reliability and internal consistency were explored. Results. The expert panel determined that the content validity was satisfactory. The final 10-item scale consisted of three factors explaining 73% of the total variance in the data. Discriminant validity was satisfactory. Internal consistency reliability (α = 0.89) and test-retest reliability (0.85) were satisfactory. The majority of the midwives and the obstetricians had a good level of knowledge while approximately one third of them had a low level of knowledge in EFM. Midwives and doctors having a lower level of knowledge related to EFM, were more frequently professionals with less than five years of clinical experience in the labor ward and reported low confidence for cardiotocography (CTG) interpretation and inadequate preparation for CTG usage.Conclusion. The EFMK demonstrated good content validity, an easily interpretable three-factor structure, high internal consistency, high test-retest reliability, and satisfactory discriminant and construct validity with sample characteristics. The EFMKS may be used for evaluating the EFM knowledge of health professionals and for identifying the areas of their knowledge gap. Based on study findings, an annual multi-professional CTG training is necessary for all intrapartum staff and in particular for the midwives and doctors with shorter clinical experience in the labor ward.

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“…Cardiotocography (CTG) is a widely used surveillance method that aims to identify fetal hypoxia to decide whether additional fetal assessment or accelerated delivery is required. However, studies show that misinterpretation of, and delayed clinical actions to, an abnormal CTG are significant etiological factors for hypoxic brain injuries during labor . In addition to the considerable effect on families and obstetric staff, these cases also result in large financial costs.…”

Section: Introductionmentioning

confidence: 99%

Curriculum development for a national cardiotocography education program: a Delphi survey to obtain consensus on learning objectives

Thellesen

Hedegaard

Bergholt

et al. 2015

Acta Obstet Gynecol Scand

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Substandard care in delivery‐related asphyxia among term infants: prospective cohort study

Abstract: Substandard care is present in a substantial number of cases with delivery-related asphyxia resulting in perinatal death or NICU admission. Improving the organization of obstetric care in the Netherlands as well as training of obstetric caregivers might reduce adverse outcomes.

Cited by 10 publications

References 29 publications

Towards a better understanding of risk selection in maternal and newborn care: A systematic scoping review

Towards a better understanding of risk selection in maternal and newborn care: A systematic scoping review

The development and psychometric evaluation of the Electronic Fetal Monitoring Knowledge Scale

Curriculum development for a national cardiotocography education program: a Delphi survey to obtain consensus on learning objectives

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