Comments for Perinatal Telehealth Project
Have just started using the new maternity call record. I do not consider it to be suitable for our purposes in Early Pregnancy. Our present documentation is both a means of ensuring reliable communication as well as assessment of women who may call.
The mat.call record is very busy with hardly any space to record detail, clinical impression or plan of care. It seems more orientated to labour, second and third trimester than any first trimester problem.
The early pregnancy assessment suite in AMU, Ayrshire is responsible for triaging women who may telephone with nausea and vomiting and any degree of pain and/or vaginal bleeding in early pregnancy.We provide care for all early pregnancy problems including ectopic pregnancy.
The majority of women who call are anxious.Anxiety will undoubtedly influence an individuals perception of pain and in my experience it is also a factor that needs to be considered as sensitively as possible with an individuals perception of blood loss in early pregnancy.If someone has heavy bleeding the need for clinical review is clear cut.The women who telephone tearful with “heavy” vaginal bleeding that requires no perineal protection need reassurance and if a midwife defers any action I believe that her rational for that decision should be absolutely transparent and this form does not lend itself to that
As this unit closes in the evening any outstanding issues are referred to the Assessment Unit who need as accurate information for any continuance of care as required.
Call outcome frequently will not fit into a tick box.
I believe the space left for subsequent calls is seriously insufficient and that the whole page would best serve the one assessment.
I don’t think our midwives have bothered to join the group – so i’m feeding back some comments they’ve made to me.
Too many questions in the call reason section!
The clinical summary section is too short a space
Generally there isn’t enough space for those with large writing.
Annette
Far too much written info requested with not enought time to complete.
time precious and need to check out various details to complete form. Takes too long.
Even patients feel we are asking too many questions.
Teresa Chivers. Maternity Department Shetland
myself and colleagues have found the form useful. Once the reason for the call has been established the other reasons can very quickly be excluded. The demographic info. although time consuming is essential for follow up. More space needed for advice given. Would also be good to have space for clinical outcome for audit purposes.
This
site is provided by Glasgow Caledonian University for NHS Scotland 
Background
In NHSScotland maternity units there is a requirement to address the high percentage of inappropriate admission of women to labour suite (‘Birthrate plus’ data suggests that 30% and above in some units of women in labour suite are category X i.e.women who have been admitted because of suspected labour, but on admission are found not to be in labour). Clearly this has implications for patient care, professional practice and resoource management.
This project is progressing the development, evaluation and implementation of an auditable clinical template and decision support tool which will assist midwives in making clinically appropriate telehealth assessment and decision making regarding women in their care e.g. whether a woman is in labour, timing of admission or requirement for a home visit.
Project Objectives:
– Develop and evidence based decision support tool to support midiwves telehealth assessment of women who think they may be in labour.
– Improved decision making will be measured by Birthrate plus data i.e. significant reduction in category X women in labour suite
– Establishment of standard of practice and system of governance for midwifery telehealth assessment
– Consideration to move to an electronic tool will be progressed following the completion of the pilot
– Full consideration of education and training requirements
Further information to be posted.
Eunice E Muir
Project Lead