Abstract
Background
‘Bundles of care’ are being implemented to improve key practice gaps in perinatal
care. As part of our development of a stillbirth prevention bundle, we consulted with
Australian maternity care providers.
Objective
To gain the insights of Australian maternity care providers to inform the development
and implementation of a bundle of care for stillbirth prevention.
Methods
A 2018 on-line survey of hospitals providing maternity services included 55 questions
incorporating multiple choice, Likert items and open text. A senior clinician at each
site completed the survey. The survey asked questions about practices related to fetal
growth restriction, decreased fetal movements, smoking cessation, intrapartum fetal
monitoring, maternal sleep position and perinatal mortality audit. The objectives
were to assess which elements of care were most valued; best practice frequency; and,
barriers and enablers to implementation.
Results
227 hospitals were invited with 83 (37%) responding. All proposed elements were perceived
as important. Hospitals were least likely to follow best practice recommendations
“all the time” for smoking cessation support (<50%), risk assessment for fetal growth
restriction (<40%) and advice on sleep position (<20%). Time constraints, absence
of clear guidelines and lack of continuity of carer were recognised as barriers to
implementation across care practices.
Conclusions
Areas for practice improvement were evident. All elements of care were valued, with
increasing awareness of safe sleeping position perceived as less important. There
is strong support from maternity care providers across Australia for a bundle of care
to reduce stillbirth.
Keywords
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Article info
Publication history
Published online: June 18, 2019
Accepted:
June 2,
2019
Received in revised form:
May 31,
2019
Received:
April 5,
2019
Identification
Copyright
© 2019 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
