Maternity Effective Handover Week Commencing W/C25.03.2024
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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 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
Maternity The Electronic Document Management (EDM) system is now LIVE. Legacy case notes for booked Maternity patients will now be sent to be scanned and made available electronically on EDM the next working day by 1pm (excluding weekends and bank holidays). How will this affect us? Maternity data clerks only: The records requested by the Maternity data clerks via the dedicated spreadsheet will now be requesting for paper records to be scanned onto EDM. The MROS team ([email protected]) will need to be cc’d when emailing the spreadsheet to Restore. The Maternity reception will be provided with the next volume (thin folder) to add new paperwork generated during the patient’s pregnancy. Please note this next volume will have a sticker on the front of the case note reminding Trust staff the patients legacy records are available on EDM. If you have access to the IPM system, you will notice that Restore has tracked the patients case notes to the scanning bureau when the case notes are in transit to be scanned.
Maternity Congratulations Sophie Bohacs has been appointed as the new Saving Babies Lives Midwife. During the interim Sophie will be working alongside Wendy. Please can you include Sophie in any relevant correspondence please. [email protected]
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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.
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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.