Maternity Effective Handover Week Commencing W/C 29.04.2024
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K2 From the new SBLv3 requirements we please have to complete a smoking assessment & CO on ALL women at 35+0-36+6 – this should just be a very quick question as to whether the woman smokes/doesn’t smoke following a CO check . Please document this under : Profile : Smoking : Add New Smoking assessment . This is now one of our mandatory audits which contributes to our CNST payments .
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Maternity Immediate learning from a recent incident: Please can we ensure, if a woman is referred to either FWBU or LWT- This must be telephoned through and communicated with the department, This includes referrals from Community and ANC. The telephone calls must be recorded on K2 so that the department can follow up if the woman DNA’s. And you ask the woman TCI – this wizard here, this recommendation page
Maternity Hi all, Going forward can you all email any K2/EPR or digital queries to [email protected] This will ensure we are able to cover the workload when team members have A/L etc. Kayleigh Astley Specialist Digital Midwife: Better Births
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Maternity Dear everyone Following on from the recent invite to the Tommy’s National preterm birth centre launch in Coventry, the launch will be held on Ward 24 in the seminar room on the 13th of May 2024 at 11.30. It is a face-to-face only meeting. As the numbers are limited, please could you confirm your attendance via the calendar invite sent. You will be able to hear a clinical talk from Professor Andy Shennan OBE who is one of the world leaders in the management of preterm birth. There will also be talks from a couple of patients from UHCW describing their experience, and clinical staff here at UHCW will also provide talks. You are also invited to a free buffet lunch immediately following the talks at 1pm in the seminar room (providing you have confirmed attendance).
Maternity Dear All There have been several datix recently where sharps have not been removed from instruments prior to the return of the instruments to sterile supplies. In the last four weeks there have been 5 sharps returned to sterile services. This is totally unacceptable. All sharps MUST be removed and accounted for at the mandatory swab count after any procedure and disposed of safely in the sharps bins. Sharps MUST NOT be left on the trays that are returned. This is a health and safety risk and puts staff in other departments at risk of a sharps injury due to the maternity team not following correct procedures.
Maternity •The EDM team are seeing a large volume in maternity paperwork go through the EDM workflow with missing PIDs on them. •There is a theme currently with MEWs chart and Midwife Attendance sheets which are being returned to areas.
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Maternity Dear All There has been a recent positive case of measles within maternity. Any staff who were exposed to the patient have been contacted and the appropriate precautions taken. Please be extra vigilant as the patient did not attend with atypical symptoms prior to a rash developing. Any patient attending with a raised temperature, flu-like symptoms generally feeling unwell, white spots in the mouth or general non-specific symptoms think could this be measles. Any patient attending with these symptoms require isolation and must wear full PPE including FFP3 masks.
Maternity Good Evening, On the back of this email sent by Sharon about the recent case of measles, can I please encourage all staff who need a repeat FIT test (this should be repeated every 2 years) to contact [email protected] to book this. We have had a poor uptake for FIT testing, and it is crucial we are retested regularly as mask availability and face shape changes over time. This is for your own protection and the protection of the families we care for.
Maternity As I’m sure you are all aware there has been a very concerning rise in the number of people catching measles in the UK. The virus spreads incredibly easily and a fall in vaccination rates is leaving more people vulnerable to infection. Please can we ask that at booking and every contact in the hospital all women are screened for Measles IGG to check for immunity. Women that are not immune should be followed up by the GP following the birth of their baby. This can be requested on CRRS using the requests/referrals tab and needs to be taken in a yellow bottle. • Select Microbiology/virology/Molecular • Serology at the bottom • Rashes-Immunity on left hand side • Tick Measles IgG Thank you for your support.
Maternity Due to EPR go live no staff will be rotated to a new area on the 15th June roster. Therefore, wherever you are allocated to work on the May roster you will stay there throughout June also. This decision has not been made lightly, it was felt that moving areas and becoming used to a new EPR system would be quite overwhelming for all staff. We are aware that this is not ideal but as this will be a challenging month for us all the decision has been made with the best intentions For those made 5 midwives on a rotation plan the CPSMs will email out the updated rotation plan shortly.
Maternity The EDM team are seeing a large volume in maternity paperwork go through the EDM workflow with missing PIDs on them. There is a theme currently with MEWs chart and Midwife Attendance sheets which are being returned to areas. Thank you.
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Maternity Dear All The survey into the homebirth/midwife-led care team has been re-opened for another couple of weeks. Over the next couple of weeks there will be some walkarounds with a tea trolley to all the areas to explain more about these proposals so please look out for information. If you have any questions or queries please contact Louise Clarke, Dee Parker or Tracy Stanbridge-Boyle for further information.
Maternity Maternity survey action plan: • Reminder to midwives to review K2/ Cerner for social/ family history when caring for women. To involve complex care team or safeguarding team for further support if needed. • Postnatal discharge leaflet to be given on admission to postnatal ward rather than on discharge. This is to encourage women to review prior to discharge. • Birth afterthoughts clinic is available for anyone who would like to discuss labour or birth in more detail. First line process is for the Patient experience midwife to speak with them first prior to a referral to PALS etc. • Community telephone triage midwife has been on maternity leave, so to prevent gaps in communication please ask all women at the end of consultation if all concerns had been addressed. If they have any questions between appts please signpost to the Ask the Midwife section on K2.
Maternity Fetal Surveillance Study Day: • Currently everyone is rostered to attend the study day every 8-10 months to help maintain your compliance. If you notice this is on your roster and you are not able to attend the day due to annual leave, please let me know asap as the study days get booked up very quickly. • If you are off on sick leave this will automatically be re-booked for you when you return. Precept: • Please can you complete as much detail on the perinatal Optimisation Passport for preterm admissions and ensure the booklet remains in the mothers notes. • You must also complete the Magnesium Sulphate & Steroids wizard once administered. This vital information is then transferred across to Badger Net for the neonatal team. This is audited monthly, currently only about 40% of staff complete the wizard. • Fresh eyes: • In extreme circumstances, that no one is available to complete a fresh eyes this can be completed by yourself and then reviewed by another practitioner as soon as possible. • The reason must be clearly documented in the contemporaneous notes
Maternity Computerised CTG: •All admissions with RFM alone after 26/40 must have a computerised. •Women presenting with second or recurrent episodes of RFM should be offered a Growth USS which should be carried out within 24 hours of attendance (During the weekend or over a public holiday a daily cCTG must be performed until a scan can be completed on the next working day) A referral to obstetrician is required for a future plan of care. This is being audited each month as it is part of Saving Babies Lives criteria which we must be achieving. •Please use the contemporaneous notes on K2 to document your actions following episodes of RFM including date of scan you have booked. •Please remember to discuss fetal movements at every contact and document discussion that has taken place. •Please refer to the RFM Guideline for more details on the management of RFM
Maternity- Risk Key messages: • Please ensure correct documentation is placed in red books when completing NIPE • Please make sure you review notes and Kardex for information and ensure Kardex is crossed through to avoid medication errors. • Please ensure all sharps are removed from instruments at the end of the procedure, at the time of the swab count and only the instruments to be returned to sterile supplies • Please ensure NEWTT observations and blood sugar monitoring are when mother is on labetalol • CRRS to be checked at every patient contact and blood group checked and recorded • Please ensure K2 documentation is checked to ensure accurate gestation is confirmed • Inpatient medication chart to be reviewed prior to discharge to ensure all medications have been prescribed at point of discharge. • Please ensure that the TTO tracker is viewed and ward fail safe used • Please ensure you dispose of patient identifiable information, theatre lists and handover forms via confidential waste. • When cannulas are inserted please add it to the wizard at the time of insertion • All ICR records to be reviewed before any administration • Medication is not to be signed for until it is administered. Learning identified following some of the recent baby readmission for jaundice and weight loss. • Feeding assessment prior to discharge for all babies. Discuss positioning and ensure effective attachment, please document this. • If mother ever states painful feeding then attachment is ineffective regardless of how it may appear so will need further investigation/referral • Please discuss CHINS and signs of effective milk transfer • To observe and document feeds at PN visits • If mother and baby are separated, support mothers to express EBM within 2 hours of birth • Weight loss of 9% would require a feeding assessment, as weight loss may be due to ineffective attachment. • If baby is on phototherapy it is key to assess breastfeeding and observe as effective feeding contributes to jaundice reduction.