Understanding staff views and experiences of a clinical practice change to reduce stillbirth in South Asian women: A cross-sectional survey.

M. Davies-Tuck, Mikayla Ruzic, Mary-Ann Davey, R. Hodges, B. Nowotny, V. Flenady, C. Andrews, E. Wallace
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引用次数: 2

Abstract

BACKGROUND In July 2017, Victoria's largest maternity service implemented a new clinical practice guideline to reduce the rates of term stillbirth in women of South Asian background. AIM To capture the views and experiences of clinical staff following the implementation of the new clinical guideline. METHODS Cross sectional survey of clinical staff providing maternity care in August 2018, 12 months post implementation. Staff were asked to provide their agreement with ten statements assessing: perceived need for the guideline, implementation processes, guideline clarity, and clinical application. Open-ended questions provided opportunities to express concerns and offer suggestions for improvement. The frequency of responses to each question were tabulated. Open ended responses were grouped together to identify themes. FINDINGS A total of 120 staff completed the survey, most (n=89, 74%) of whom were midwives. Most staff thought the rationale (n=95, 79%), the criteria for whom they applied (83%, n=99), and the procedures and instructions within the guideline were clear (74%, n=89). Staff reported an increase in workload (72%, n=86) and expressed concerns related to rationale and evaluation of the guidelines, lack of education for both staff and pregnant South Asian women, increased workload and insufficient resources, patient safety and access to care. Challenges relating to shared decision making and communicating with women whose first language is not English were also identified. DISCUSSION This study has identified key barriers to and opportunities for improving implementation and highlighted additional challenges relating to new clinical guidelines which focus on culturally and linguistically diverse women.
了解工作人员对减少南亚妇女死产的临床实践改变的看法和经验:一项横断面调查。
2017年7月,维多利亚州最大的产科服务机构实施了一项新的临床实践指南,以降低南亚背景妇女的足月死产率。目的收集临床工作人员在实施新的临床指引后的意见和经验。方法对实施后12个月,即2018年8月提供产科护理的临床工作人员进行横断面调查。工作人员被要求提供他们对十项声明的同意,评估:对指南的感知需求、实施过程、指南的清晰度和临床应用。开放式问题提供了表达关注和提出改进建议的机会。每个问题的回答频率被制成表格。开放式回答被分组在一起以确定主题。结果共有120名工作人员完成了调查,其中大部分(n= 89,74 %)是助产士。大多数员工认为指南的基本原理(n=95, 79%)、适用的标准(83%,n=99)以及指南内的程序和说明是明确的(74%,n=89)。工作人员报告工作量增加(72%,n=86),并对指南的理由和评估、工作人员和南亚孕妇缺乏教育、工作量增加和资源不足、患者安全和获得护理表示担忧。报告还指出,在共同决策和与母语不是英语的女性沟通方面存在挑战。本研究确定了改进实施的主要障碍和机会,并强调了与新的临床指南相关的额外挑战,这些指南关注文化和语言不同的女性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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