Maternity Effective Handover Week Commencing 19/06/2023
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Trust Although many of us are enjoying the sun, it is also a time to remember to hydrate, with this in mind please ensure staff stay hydrated during their workday and our patients are offered extra drinks. If staff want to, they can wear their uniform without tights. Please make sure that all staff still wear appropriate footwear and maintain the uniform standards, continuing to promote a professional appearance. Emma Fish Associate Director of Nursing, Quality and Patient Safety
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Maternity Reporting Procedure for Broken and Transferring Beds Broken Beds When a bed is broken the following actions need to be followed • Report bed on help desk Ext 25555 obtain a ref number and put on decontamination form. (These are available from your ward clerk/ COP 222 on e-library). • • Undertake social clean with Tristel removing any linen and fire evacuation sheets which will need to be sent to the Laundry Service. Any replacement sheets required will need to be ordered from the linen room. • • Fully complete the decontamination certificate following IPC guidance and secure certificate to the bed once socially cleaned. • • Remove bed from ward and place in designated storage space on the rear hub areas between wards (east and west wing) NOT in main street. •
Maternity Congratulations to Ockenden Assurance Lead Midwife, Charlene Cole, whose work establishing the Maternity Safety Network has been recognised in the HSJ Patient Safety - shortlisted for Maternity and Midwifery Initiative of Year.
Maternity Working Beds to be transferred. 1. Report bed on help desk Ext 25555 obtain a ref number and put on decontamination form. 1. Undertake social clean with Tristel, removing any linen and fire evacuation sheets which will need to be sent to the Laundry Service. Any replacement sheets required will need to be ordered from the linen room. 1. Place a green and white I AM CLEAN TAG on the bed with the required ward information. 1. Remove bed from ward and place in designated storage space on the rear hub areas between wards (east and west wing) NOT in main street.
Maternity Safeguarding Adults Level 3 Training. Three ways to obtain this competence, 1,2 or 3. 1. Attend face to face training in the Clinical Science Building Face to face training is offered 18th July 8.30-13.00 22nd August 13.00-15.00 Book on via ESR 2. Micro Soft Teams training is offered. 7 th July Friday 9.00-12.30 4 th August 9.00-12.30 Book on via ESR 3. Or follow pathway to obtain competence from the three modules online. Follow attached pathway to complete modules. Please do not hesitate to contact the Safeguarding Team with any queries about the training offer. Via email the adult safeguarding box on Adult Safeguarding - [email protected] Or phone 02476966684 ext.26684
Maternity Hi everyone Channel 5 Trauma TV series – filming 20 June to 19 August at UH and Rugby St Cross I think most people will have had some conversation with us by now about the planned arrival of a new TV series for Channel 5 which we will be filming from 20 June to mid August. There will be a small team of 8-12 people on site at UH Tues- Saturday (sometimes Sunday) including four small camera crews of two from a company called Full Fat TV. The programme will be broadcast September to October at prime time 9pm and will be focused on Trauma particularly through the lens of road traffic collisions. We will be wishing to showcase the whole patient journey and all the staff who help get them on the road to recovery. The TV series are looking for positive stories showing the great care we give – and to assure you that its not like BBC Panorama or Hospital where they are about how the NHS is managed. They will be filming from the point air ambulance arrives at the scene and then following those patients from arrival at UH where trauma team will coordinate response through to surgery and rehab for example. We will also hope to include any other road collisions that may come in via road ambulance where possible. It is our intention to also ensure we film staff patients at Rugby too particularly those having therapies after operations. We will wish to feature all those involved including bloods, imaging, catering, cleaning and the range of people who care for our patients. Initially we will be filming a bit more at the front door as we get these stories started but we will be wanting to follow them into theatres, on wards, having tests and on their road to recovery through therapies etc. If you have any stories of patients on your wards or clinics who have been involved in road traffic collisions who you think would make a great case study – please let us know asap?
Maternity We will have an editorial panel including trauma and emergency department colleagues fact checking any coverage before anything is broadcast to check it is an accurate reflection of the story. There are rigorous processes around consent as you know. That said it is important to let the crews know if you have particular staff who do not wish to be filmed. I am told there are many options to this including – “happy to have my hand filmed doing the operation, or the back of my head but don’t want my face in…to happy to be filmed”. Hopefully many of our staff will help support us doing this and showing the great work they do and I know how much them and their families said they enjoyed the last time we did this. The actual filming will start from Tuesday 20th June and the company will be starting its research and planning with us here this week – their team will be wearing red lanyards to be identifiable. Their back office team will be based alongside communications in third floor exec offices but you may see the crews around the hospital. In order to do this well, we will want to try and get as many patient stories underway as soon as we can – so we will be looking for recent ones involving patients that were in a road /bike /motorbike /e-scooter collision or may have been a pedestrian caught up in events, but we will then follow those up with Channel 5I know we are all busy but we will try to do this as smoothly as we can – any concerns or issues we need to resolve, please just speak to either Natalie on ext 27597 or myself x27613. We do see a big jump in interest for joining our hospital after these programmes, so there are some real positive benefits to doing this kind of work. Lynda Scott (She/Her) Director of Marketing and Communications Communications Team
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Maternity K2: Please can all midwives complete intermittent Auscultation: it is your responsibility to ensure you are up to date with this midwifery skill. This online training is classed as your annual update. Once completed please email Wendy Taylor so the compliance spread sheet can be updated. PRECEPT: Magnesium sulphate & Steroids wizard must be completed when administered. This vital information is then transferred across to Badger Net for the neonatal team. Computerised CTG: All admissions with RFM alone after 26/40 must have a computerised CTG as this forms part of Saving Babies Lives recommendations, as well part of our CNST compliance. If you need any further training, please contact Wendy Taylor or the manager of Triage or FWB. Fresh eyes: Please continue to complete fresh eyes hourly you are all doing extremely well with compliancy we are on average 95% compliant. Please remember they are done on the hour by a different practioner, if there is no one to complete the review due to a clinical emergency you may complete it yourself, but you must document the reason why you have completed it and then ask a colleague to complete it asap (this will mean there are two reviews completed for this Hour!) RFM: Please remember to discuss fetal movements at every contact, and any concerns to contact Triage
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Maternity The fetal monitoring in labour guideline has now been updated and approved, it will be available in the trusts Elibrary, please ensure you are familiar with the updated NICE 2022 changes: These are some of the changes, which are currently being discussed on the fetal Surveillance Study day, if you need further guidance, please inform Wendy Taylor. However it is important you review the guidelines to have a full understanding of the changes. 1. Categorise CTG traces as follows, based on whether each of the 4 features (contractions, baseline, variability, decelerations) have been scored as white, amber or red. · Normal CTG (White ) no amber or red features (all 4 features are white) · Suspicious CTG (Amber) any 1 feature is amber · Pathological CTG (Red) any 1 feature is red, or 2 or more features are amber. NICE 2017, amended 2022
Maternity WHITE AMBER RED CONTRACTIONS <5 in ten mins 5 or more in 10 mins- leading to reduced resting time between contractions or Hypertonus uterus BASELINE FETAL HEART RATE Stable baseline 110-160bpm • Increase of Fetal heart rate of 20 beats or more from the start of labour or since the last review 1HR previously • 100-109 bpm or • unable to determine baseline Below 100bpm or above 160bpm VARIABILITY 5-25 bpm • < 5 bpm for 30-50mins • More than 25bpm for up to 10mins • <5 bpm for >50mins • >25BPM for >10mins • Sinusoidal pattern DECELERATIONS • No decelerations • Early decelerations • Variable decelerations with no concerning features • Repetitive Variable decelerations with concerning features <30 mins • Repetitive late decelerations <30mins • Repetitive variable decelerations with concerning >30mins • Acute Bradycardia • Single prolonged decelerations >3mins or more ACCELERATIONS • The presence of fetal heart rate accelerations, even with reduced variability, is generally a sign that the baby is healthy • The absence of accelerations on an otherwise normal CTG trace does not indicate fetal acidosis
Maternity 2. Fetal Blood Sampling (NICE 2022) NICE is unable to make a recommendation about fetal blood sampling because of limited evidence.At UHCW and in line with our Physiological CTG training over the past few years we have decided to stop the use of FBS especially with NICE new guidance. NICE committee agreed that the risks of fetal blood sampling were not balanced by the benefits and agreed it was no longer appropriate to recommend fetal blood sampling and they considered making a recommendation to advise that it should not be used. However, the committee were aware of an ongoing research study comparing fetal scalp stimulation with fetal blood sampling on maternal and fetal outcomes (FIRSST study) and did not wish to make recommendations which may impact on the completion of this study. The committee therefore agreed to make a recommendation advising on the current lack of evidence to support fetal blood sampling. 3. Usage of Terbutaline for uterine hyperstimulation
Maternity- Risk Key messages: • Staff are reminded to document breastfeeding support and to observe the effectiveness of feeds with Infants at risk of hypoglycaemia. • Following a recent incident of a maternal cardiac arrest please can all staff ensure: Any woman requiring oxygen on the antenatal and postnatal ward is transferred to Labour Ward immediately and receives a medical review. • Staff are encouraged to have discussions with parents of cue recognition and signs of effective attachment. Observations of feeds is a must. • Regular feeding documentation and breastfeeding assessments for all babies is required, especially with babies at risk of hypoglycaemia. All staff are welcome to attend the Maternity safety huddle every Tuesday at 14.00 in the Ward 24 seminar room