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Assessment of the quality, content and perceived utility of local maternity guidelines in hospitals in England implementing the saving babies’ lives care bundle to reduce stillbirth
- Source :
- BMJ Open Quality, Vol 9, Iss 2 (2020), BMJ Open Quality, Lau, Y Z, Widdows, K, Roberts, S A, Khizar, S, Stephen, G L, Rauf, S & Heazell, A 2020, ' Assessment of the quality, content and perceived utility of local maternity guidelines in hospitals in England implementing the Saving Babies’ Lives Care Bundle to reduce stillbirth ', BMJ Open Quality . https://doi.org/10.1136/bmjoq-2019-000756
- Publication Year :
- 2020
- Publisher :
- BMJ Publishing Group, 2020.
-
Abstract
- IntroductionThe UK Department of Health have targeted a reduction in stillbirth by 50% by 2025; to achieve this, the first version of the Saving Babies’ Lives Care Bundle (SBLCB) was developed by NHS England in 2016 to improve four key areas of antenatal and intrapartum care. Clinical practice guidelines are a key means by which quality improvement initiatives are disseminated to front-line staff.MethodsSeventy-five clinical practice guidelines covering the four areas of antenatal and intrapartum care in the first version of SBLCB were obtained from 19 maternity providers. The content and quality of guidelines were evaluated using the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool. Maternity health professionals in participating organisations were invited to participate in an anonymous survey to determine perceptions toward and experiences of the use of clinical practice guidelines using a series of Likert scales.ResultsUnit guidelines showed considerable variation in quality with median scores of 50%–58%. Only 4 (5.6%) guidelines were recommended for use in clinical practice without modifications, 54 (75.0%) were recommended for use subject to modifications and 12 (16.7%) were not recommended for use. The lowest scoring domains were ‘rigour of development’, ‘stakeholder involvement’ and ‘applicability’. A significant minority of unit guidelines omitted recommendations from national guidelines. The majority of staff believed that clinical practice guidelines standardised and improved the quality of care but over 30% had insufficient time to use them and 24% stated they were unable to implement recommendations.ConclusionTo successfully implement initiatives such as the SBLCB change is needed to local clinical practice guidelines to reduce variation in quality and to ensure they are consistent with national recommendations . In addition, to improve clinical practice, adequate time and resources need to be in place to deliver and evaluate care recommended in the SBLCB.
- Subjects :
- Adult
Quality management
Leadership and Management
medicine.medical_treatment
media_common.quotation_subject
reduced fetal movements
Rigour
Unit (housing)
Likert scale
fetal growth restriction
03 medical and health sciences
0302 clinical medicine
Nursing
Obstetrics and gynaecology
intrapartum fetal monitoring
Pregnancy
Surveys and Questionnaires
obstetrics and gynaecology
Medicine
Humans
Quality (business)
Maternal Health Services
030212 general & internal medicine
media_common
Quality of Health Care
Original Research
lcsh:R5-920
030219 obstetrics & reproductive medicine
business.industry
Health Policy
Public Health, Environmental and Occupational Health
Stakeholder
Stillbirth
AGREE II
Quality Improvement
Hospitals
smoking cessation
England
Smoking cessation
Female
business
healthcare quality improvement
lcsh:Medicine (General)
clinical practice guidelines
Patient Care Bundles
Saving Babies Lives Care Bundle
Subjects
Details
- Language :
- English
- ISSN :
- 23996641
- Volume :
- 9
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- BMJ Open Quality
- Accession number :
- edsair.doi.dedup.....bd7d2765c59d6f37ca770404edbafcd8
- Full Text :
- https://doi.org/10.1136/bmjoq-2019-000756