BACKGROUND: Deficiencies in investigation and audit of perinatal deaths result in loss of information thereby limiting strategies for future prevention. The Perinatal Society of Australia and New Zealand (PSANZ) developed a clinical practice guideline for perinatal mortality in 2004. AIMS: To determine the current use and views of the PSANZ guideline, focussing on the investigation and audit aspects of the guideline. METHODS: A telephone survey was conducted of lead midwives and doctors working in birth suites of maternity hospitals with over 1000 births per annum in Australia and New Zealand. RESULTS: Sixty-nine of the 78 eligible hospitals agreed to participate. A total of 133 clinicians were surveyed. Only 42% of clinicians surveyed were aware of the guideline; more midwives than doctors were aware (53 vs 28%). Of those, only 19% had received training in their use and 33% reported never having referred to them in practice. Implementation of even the key guideline recommendations varied. Seventy per cent of respondents reported regularly attending perinatal mortality audit meetings; midwives were less likely than doctors to attend (59 vs 81%). Almost half (45%) of those surveyed reported never receiving feedback from these meetings. The majority of clinicians surveyed agreed that all parents should be approached for consent to an autopsy examination of the baby; however, most (86%) reported the need for clinician training in counselling parents about autopsy. CONCLUSIONS: Effective implementation programmes are urgently required to address suboptimal uptake of best practice guidelines on perinatal mortality audit in Australia and New Zealand.
BACKGROUND: Deficiencies in investigation and audit of perinatal deaths result in loss of information thereby limiting strategies for future prevention. The Perinatal Society of Australia and New Zealand (PSANZ) developed a clinical practice guideline for perinatal mortality in 2004. AIMS: To determine the current use and views of the PSANZ guideline, focussing on the investigation and audit aspects of the guideline. METHODS: A telephone survey was conducted of lead midwives and doctors working in birth suites of maternity hospitals with over 1000 births per annum in Australia and New Zealand. RESULTS: Sixty-nine of the 78 eligible hospitals agreed to participate. A total of 133 clinicians were surveyed. Only 42% of clinicians surveyed were aware of the guideline; more midwives than doctors were aware (53 vs 28%). Of those, only 19% had received training in their use and 33% reported never having referred to them in practice. Implementation of even the key guideline recommendations varied. Seventy per cent of respondents reported regularly attending perinatal mortality audit meetings; midwives were less likely than doctors to attend (59 vs 81%). Almost half (45%) of those surveyed reported never receiving feedback from these meetings. The majority of clinicians surveyed agreed that all parents should be approached for consent to an autopsy examination of the baby; however, most (86%) reported the need for clinician training in counselling parents about autopsy. CONCLUSIONS: Effective implementation programmes are urgently required to address suboptimal uptake of best practice guidelines on perinatal mortality audit in Australia and New Zealand.
Authors: Kate J Kerber; Matthews Mathai; Gwyneth Lewis; Vicki Flenady; Jan Jaap H M Erwich; Tunde Segun; Patrick Aliganyira; Ali Abdelmegeid; Emma Allanson; Nathalie Roos; Natasha Rhoda; Joy E Lawn; Robert Pattinson Journal: BMC Pregnancy Childbirth Date: 2015-09-11 Impact factor: 3.007
Authors: Paul A Gardiner; Alison L Kent; Viviana Rodriguez; Aleena M Wojcieszek; David Ellwood; Adrienne Gordon; Patricia A Wilson; Diana M Bond; Adrian Charles; Susan Arbuckle; Glenn J Gardener; Jeremy J Oats; Jan Jaap Erwich; Fleurisca J Korteweg; T H Nguyen Duc; Susannah Hopkins Leisher; Kamal Kishore; Robert M Silver; Alexander E Heazell; Claire Storey; Vicki Flenady Journal: BMC Pregnancy Childbirth Date: 2016-11-25 Impact factor: 3.007
Authors: Janet I Vaughan; Heather E Jeffery; Camille Raynes-Greenow; Adrienne Gordon; Jane Hirst; David A Hill; Susan Arbuckle Journal: BMC Med Educ Date: 2012-11-06 Impact factor: 2.463