A national cross sectional survey of heads of midwifery services of uptake, benefits and barriers to use of obstetric early warning systems (EWS) by midwives

Authors: Bick, D.E., Hundley, V., Thomas, S., Smith, G.B. et al.

Journal: Midwifery

Volume: 30

Issue: 11

Pages: 1140-1146

ISSN: 0266-6138

DOI: 10.1016/j.midw.2014.03.016

Abstract:

Objective: to identify the extent to which Early Warning Systems (EWS) are used by midwives in the United Kingdom (UK), the maternity settings they are used in, physiological parameters used to 'trigger' referral, training provision, barriers to implementation and role in preventing maternal morbidity. Design: cross-sectional survey of heads of midwifery services. An email questionnaire was sent in September 2012. Setting: UK NHS secondary care organisations providing maternity care. Findings: heads of midwifery from 107 (68%) of 157 NHS organisations responded, with 108 questionnaires returned as two organisations had recently merged. All organisations, apart from one which only had a free-standing midwifery unit, had introduced EWS. Nearly all respondents (99%) reported EWS were used by midwives antenatally, 76% in labour and 100% on the postnatal ward. All EWS charts included body temperature, heart rate, respiratory rate, systolic blood pressure and oxygen saturation although parameters for escalation varied widely. Barriers to use of EWS by midwives included overlap with the partogram in labour, and staff shortages and delays obtaining clinical review when referral was triggered. Two-thirds considered EWS prevented maternal morbidity although few could provide supporting evidence, for example, audit findings. Training for midwives in use of EWS was available in 83% of organisations. Conclusion: most UK midwives are using EWS, with the highest use in obstetric units. The heterogeneity of EWS currently used potentially limits collation of evidence to inform appropriate system level responses. Research is needed to evaluate the role of EWS to prevent maternal morbidity during and after pregnancy in different maternity settings.

http://eprints.bournemouth.ac.uk/22169/

Source: Scopus

A national cross sectional survey of heads of midwifery services of uptake, benefits and barriers to use of obstetric early warning systems (EWS) by midwives.

Authors: Bick, D.E., Sandall, J., Furuta, M., Wee, M.Y.K., Isaacs, R., Smith, G.B., Beake, S. and Modified Obstetric Early Warning Systems (Mobs) Research Group

Journal: Midwifery

Volume: 30

Issue: 11

Pages: 1140-1146

eISSN: 1532-3099

DOI: 10.1016/j.midw.2014.03.016

Abstract:

OBJECTIVE: to identify the extent to which Early Warning Systems (EWS) are used by midwives in the United Kingdom (UK), the maternity settings they are used in, physiological parameters used to 'trigger' referral, training provision, barriers to implementation and role in preventing maternal morbidity. DESIGN: cross-sectional survey of heads of midwifery services. An email questionnaire was sent in September 2012. SETTING: UK NHS secondary care organisations providing maternity care. FINDINGS: heads of midwifery from 107 (68%) of 157 NHS organisations responded, with 108 questionnaires returned as two organisations had recently merged. All organisations, apart from one which only had a free-standing midwifery unit, had introduced EWS. Nearly all respondents (99%) reported EWS were used by midwives antenatally, 76% in labour and 100% on the postnatal ward. All EWS charts included body temperature, heart rate, respiratory rate, systolic blood pressure and oxygen saturation although parameters for escalation varied widely. Barriers to use of EWS by midwives included overlap with the partogram in labour, and staff shortages and delays obtaining clinical review when referral was triggered. Two-thirds considered EWS prevented maternal morbidity although few could provide supporting evidence, for example, audit findings. Training for midwives in use of EWS was available in 83% of organisations. CONCLUSION: most UK midwives are using EWS, with the highest use in obstetric units. The heterogeneity of EWS currently used potentially limits collation of evidence to inform appropriate system level responses. Research is needed to evaluate the role of EWS to prevent maternal morbidity during and after pregnancy in different maternity settings.

http://eprints.bournemouth.ac.uk/22169/

Source: PubMed

A national cross sectional survey of heads of midwifery services of uptake, benefits and barriers to use of obstetric early warning systems (EWS) by midwives

Authors: Bick, D.E., Sandall, J., Furuta, M., Wee, M.Y.K., Isaacs, R., Smith, G.B., Beake, S. and Syst, M.O.E.W.

Journal: MIDWIFERY

Volume: 30

Issue: 11

Pages: 1140-1146

eISSN: 1532-3099

ISSN: 0266-6138

DOI: 10.1016/j.midw.2014.03.016

http://eprints.bournemouth.ac.uk/22169/

Source: Web of Science (Lite)

A national cross sectional survey of heads of midwifery services of uptake, benefits and barriers to use of obstetric early warning systems (EWS) by midwives

Authors: Bick, D.E., Sandall, J., Furuta, M., Wee, M.Y.K., Isaacs, R., Smith, G.B., Beake, S. and on behalf of the Modified Obstetric Early Warning Systems (Mobs) Research Group

Journal: Midwifery

http://eprints.bournemouth.ac.uk/22169/

Source: Manual

Preferred by: Vanora Hundley

A national cross sectional survey of heads of midwifery services of uptake, benefits and barriers to use of obstetric early warning systems (EWS) by midwives.

Authors: Bick, D.E., Sandall, J., Furuta, M., Wee, M.Y.K., Isaacs, R., Smith, G.B., Beake, S. and Modified Obstetric Early Warning Systems (Mobs) Research Group

Journal: Midwifery

Volume: 30

Issue: 11

Pages: 1140-1146

eISSN: 1532-3099

ISSN: 0266-6138

DOI: 10.1016/j.midw.2014.03.016

Abstract:

Objective

to identify the extent to which Early Warning Systems (EWS) are used by midwives in the United Kingdom (UK), the maternity settings they are used in, physiological parameters used to 'trigger' referral, training provision, barriers to implementation and role in preventing maternal morbidity.

Design

cross-sectional survey of heads of midwifery services. An email questionnaire was sent in September 2012.

Setting

UK NHS secondary care organisations providing maternity care.

Findings

heads of midwifery from 107 (68%) of 157 NHS organisations responded, with 108 questionnaires returned as two organisations had recently merged. All organisations, apart from one which only had a free-standing midwifery unit, had introduced EWS. Nearly all respondents (99%) reported EWS were used by midwives antenatally, 76% in labour and 100% on the postnatal ward. All EWS charts included body temperature, heart rate, respiratory rate, systolic blood pressure and oxygen saturation although parameters for escalation varied widely. Barriers to use of EWS by midwives included overlap with the partogram in labour, and staff shortages and delays obtaining clinical review when referral was triggered. Two-thirds considered EWS prevented maternal morbidity although few could provide supporting evidence, for example, audit findings. Training for midwives in use of EWS was available in 83% of organisations.

Conclusion

most UK midwives are using EWS, with the highest use in obstetric units. The heterogeneity of EWS currently used potentially limits collation of evidence to inform appropriate system level responses. Research is needed to evaluate the role of EWS to prevent maternal morbidity during and after pregnancy in different maternity settings.

http://eprints.bournemouth.ac.uk/22169/

Source: Europe PubMed Central

A national cross sectional survey of heads of midwifery services of uptake, benefits and barriers to use of obstetric early warning systems (EWS) by midwives

Authors: Bick, D.E., Smith, G.B., van Teijlingen, E., Hundley, V., Thomas, S. et al.

Journal: Midwifery

Volume: 30

Issue: 11

Pages: 1140-1146

ISSN: 0266-6138

Abstract:

Objective

to identify the extent to which Early Warning Systems (EWS) are used by midwives in the United Kingdom (UK), the maternity settings they are used in, physiological parameters used to ‘trigger’ referral, training provision, barriers to implementation and role in preventing maternal morbidity.

Design

cross-sectional survey of heads of midwifery services. An email questionnaire was sent in September 2012.

Setting

UK NHS secondary care organisations providing maternity care.

Findings

heads of midwifery from 107 (68%) of 157 NHS organisations responded, with 108 questionnaires returned as two organisations had recently merged. All organisations, apart from one which only had a free-standing midwifery unit, had introduced EWS. Nearly all respondents (99%) reported EWS were used by midwives antenatally, 76% in labour and 100% on the postnatal ward. All EWS charts included body temperature, heart rate, respiratory rate, systolic blood pressure and oxygen saturation although parameters for escalation varied widely. Barriers to use of EWS by midwives included overlap with the partogram in labour, and staff shortages and delays obtaining clinical review when referral was triggered. Two-thirds considered EWS prevented maternal morbidity although few could provide supporting evidence, for example, audit findings. Training for midwives in use of EWS was available in 83% of organisations.

Conclusion

most UK midwives are using EWS, with the highest use in obstetric units. The heterogeneity of EWS currently used potentially limits collation of evidence to inform appropriate system level responses. Research is needed to evaluate the role of EWS to prevent maternal morbidity during and after pregnancy in different maternity settings.

http://eprints.bournemouth.ac.uk/22169/

Source: BURO EPrints