effective handover 15th aug

Maternity Effective Handover

Week Commencing 15th August 2022

Trust

Trust

Trust

Trust

Trust

EPR

Maternity

As you are aware, we currently still use Perinatal Institute (PI) growth charts (GROW
1.5 application) for our out of area women and K2 growth charts for UHCW women.
Going forward from October 2022 we will be moving away from K2 growth charts and
will be implementing an updated PI GROW 2.0 application.
Therefore, any woman booking their pregnancy at UHCW will have a PI growth chart
generated. Initially, this will be on a separate standalone system but going forward
when we launch the new EPR system this will be integrated and seamless.
As part of the roll out of GROW 2.0 we would be grateful if you could please watch
the full GROW 2.0 training-
https://pinstitute.sharepoint.com/sites/ExternalFiles/Shared%20Documents/Form
s/AllItems.aspx?id=%2Fsites%2FExternalFiles%2FShared%20Documents%2FRecordi
ngs%2FGROW%202%2E0%20Training%20Video%2Emp4&parent=%2Fsites%2FExter
nalFiles%2FShared%20Documents%2FRecordings&p=true&wdLOR=cB6B27062%2D
53FB%2D4D6D%2D8504%2DB7505CDE961F&ct=1659621526584&or=Outlook-
Body&cid=EBD0DBE2-E931-48A5-A087-377FD85983B7&ga=1
I would be grateful if you could watch the 30 minute video by the 20th August 2022
and email [email protected] or [email protected] with
your completed declaration

K2

K2 Athena Updates included:

• Nationally mandated Public Health requirements for Smoking
and Vaccinations

• New referrals to SAMS (substance misuse), Lucina and
MAMTA

• Risk assessment updates
• Health Visitor access to a complete booking summary on

CRRS
• Various changes made to FGR Risk Assessment
• Two new text labels created, one for 'Previous Baby Loss' and

one for 'Current Baby Loss' that will display along with the
SANDS Icon

K2 Athena Interface to commence next week:

• Pathology interface with K2 and CRRS





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Maternity

New Starters

We have had a new bereavement Midwife Mandy Price start this
week
A new Diabetes Midwife starting on 5/9/22
An Antenatal ward manager Victoria Jones commencing the 15/8/22
And Helen Nicholls Practice Development Midwife will be starting on
12/9/22

We also have in the pipeline an additional:
• 9 HCA’s
• 5 Band 6 midwives
• 27 Band 5 Midwives
• 5 Bank Midwives
• 2 band 3 MSW’s

Carrie Daniels

Maternity

Midwives who complete and suspect the
baby has tongue tie can you please write
‘Suspected tongue tie’ and not ‘tongue tie
noted’ as we are having to pay out £75 due
to a midwife miss-diagnosing one as the
patient went private to find out the baby
actually didn’t have tongue tie.

Louise Tartarelli
Patient Experience Midwife

Maternity

The CPSM Bleep is
now back in use.
CPSMs can be
contacted on #5119.

CPSM Team

Maternity

National Healthcare Uniform Workforce
Consultation

The wearer trial stage of this process is now complete, we
are currently finalising the design, and once it is ready we
will be in a position to issue the final tender. Due to public
sector procurement regulations, we are unable to share
more specific information at this stage, however, as soon
as we can, we will share a more detailed update (including
the next steps and project timescales).

NHS Supplier
Chain

Maternity

Maternity

Maternity

Maternity

Maternity

Maternity

As per trust standard all staff who
predominantly work nights are required
to work 2 weeks of days every 12
months, this does not include any study
days attended.
This is a mandatory requirement and all
staff will be allocated a consecutive 2
weeks on the rosters.

Sharon Gouldingay
Modern Matron for Antenatal and
Postnatal inpatient services

Maternity

Weekly Key Message

Please remember that CO monitoring is to be
completed at EVERY antenatal appointment
alongside BP and urinalysis
K2 risk assessments to be completed at EVERY
CONTACT! Current compliance is only 10%

Charlene Cole

CNST Midwife

Clinical Risk

All datixs are reviewed at the Maternity Grand Safety huddle, every Tuesday afternoon 2-3pm in
the ward 24 seminar room and on Microsoft teams. Everyone is welcome to attend!

Key issues identified;
• All entries onto K2 must be checked as correct by staff inputting data
• All staff to ensure good communication between areas particularly in times of high
acuity to ensure safe patient care
• Station of fetal head should always be well ascertained when assessing Bishop
score prior to ARM
• Ensure drug kardex is thoroughly reviewed on admission to the ward to avoid
omitted drugs
• Ensure emergency equipment must be ready to use in the event of an emergency

Datix investigators – If you need any help closing datixs please let me know. There are currently 250
open datixs.

Clinical Risk

CTG

K2 Online Learning: It is your own responsibility to ensure your K2 online learning is completed before it expires, everyone is sent a
reminder 6 weeks before it expires with weekly reminders being sent until it is complete. K2 forms part of safety for maternity and is a
mandatory requirement. If you are having problems accessing your online account please let Wendy Taylor know who can look in to it.

The mandatory chapters are:

CTG hourly reviews:

To comply with SBLV2, fresh eyes and fresh ears must be carried out by an individual practioner not the primary midwife looking after the
patient:

All Fresh Eyes and Fresh Ears must be carried out every hour on the hour by a second independent midwife /obstetrician to assess fetal
wellbeing during intrapartum care. (This means you will not complete your own hourly fresh eyes / fresh ears, however you may be asked
to complete one of your colleagues instead).

The hourly review must include evaluation of the FHR as well as a classification of the CTG or Intermittent Auscultation and should
comprise of risk factors such as persistently reduced fetal movements before labour, fetal growth restriction, previous caesarean section,
thick meconium, suspected infection, vaginal bleeding or prolonged labour, any changes must be documented and should lead to
escalation if indicated. Please can you ensure at each review there is clear documentation that a 2nd midwife/Obstetrician is present,
they should be logging in to K2 with their finger print to confirm the assessment as this will now perform part of our auditing criteria.
However, the primary midwife should still be reviewing and documenting the fetal heart at each stage of labour according to the
intrapartum fetal surveillance guideline.
If you have asked for a Doctor to review A CTG or any reviews carried out on the ward round the CTG wizard must be used this allows for
a formal assessment of the CTG as well as the whole clinical picture:

CTG teaching: These teaching sessions are back up and running on Monday and Friday mornings, please join via teams the sessions
are 8-8.30 and are a really useful way of learning and developing. If you have any interesting cases you would like to discuss please
contact Wendy Taylor who is more than happy to either support you in presenting them or will present them on your behalf

CTG

PRECEPT: MgSo4 & Steroids:
Please complete the Antenatal Steroid and Magnesium Sulphate Wizards on K2,
so accurate and up to date information can be transferred across to Badger Net.
These are essential data, form a part of NNAP dashboard and we are mapped
against performance and compliance and this is audited every month.

CTG

Prevention of Cerebral Palsy in Pre-Term Labour (PReCePT)

PReCePT Compliance:

June 2022: 86% 1out of 7 babies did not receive Mgso4 for neuroprotection

July 2022: 100%

Learning from x1 missed case June 2022

History:

G2 P1 previous C/s at fully for fetal distress in November 2020

Transferred care to UHCW @ 23/40

BMI at booking 34.63

Sickle cell carrier

Non smoker

GDM on Metformin

Booked under Consultant Care

Growths scan @ 24+4 placental site anterior upper growth on 57th Centile

24+6 Seen in LWT 1st episode of RFM reviewed discharged home RFM information given

26+3 Consultant clinic appointment and follow up with diabetic team plan: growth scan in 2/52 and consultant ANC.
Mode of delivery discussed for c/s @ 39/40

CTG

27+6 Seen in LWT c/o abdo pain: Abdomen soft and non-tender on palpation, c/o of abdominal pain
since the previous day. MSU +++ Leucocytes & ++Nitrates. No evidence of srom, Actim Partus
positive, no PV Bleeding OS closed. HVS and urine sample sent to lab. CTG tachycardic on
admission.

HB 105 CRP WCC 11.27 CRP 45. 1st antenatal steroid administered.

Plan for admission to ward 24 for observations, commence on ABX for UTI. Observe for vaginal
bleeding, contractions or abdo pain.

During admission to ward VRIII commenced and 2nd steroid administered. CTG tachycardic at times
reviewed by consultant normal CTG for gestation.

3 days following admission:

04.13: CTG commenced as patient c/o of abdo pain and pink watery loss Dr bleeped and asked to
review

04.49: Dr bleeped again and asked to review with regards to above as well as an abnormal antenatal
CTG (High Baseline, reduced variability and variable decelerations)

04.50: Now contracting 4: 10

05.06: Doctor asked to attend as still not on ward

05.07: Bulging membranes seen at introitus

05.08: 2222 emergency call escalated

05.10 Fore-water Srom and vertex visible and advancing. Baby delivered

CTG

Good Points:

• Antenatal steroids given and VRIII commenced
• Patient admitted for close observations

Learning Points:

• The Actim Partus performed was positive and there was also
evidence of a UTI infection

• No formal documentation regarding consultant on call being
informed of admission with regard to commencing MgSO4

• If a pre-term is contracting on the ward they must be transferred
to labour ward for 1:1 care. In particular if the Doctors are not
able to attend and review immediately.

PReCePT

Magnesium sulphate (MgSO4) is given to pregnant women at risk of
preterm birth with the intention of preventing cerebral palsy and
other adverse neurodevelopmental outcomes, to enable every baby
to reach their full potential.