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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2019

Open Access 01-12-2019 | Care | Research article

Identifying and prioritising midwifery care process metrics and indicators: a Delphi survey and stakeholder consensus process

Authors: Declan Devane, Nora Barrett, Anne Gallen, Mary Frances O’Reilly, Margaret Nadin, Gillian Conway, Linda Biesty, Valerie Smith

Published in: BMC Pregnancy and Childbirth | Issue 1/2019

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Abstract

Background

Measuring care processes is an important component of any effort to improve care quality, however knowing the appropriate metrics to measure is a challenge both in Ireland and other countries. Quality of midwifery care depends on the expert knowledge of the midwife and her/his contribution to women and their babies’ safety in the healthcare environment. Therefore midwives need to be able to clearly articulate and measure what it is that they do, the dimensions of their professional practice frequently referred to as midwifery care processes. The objective of this paper is to report on the development and prioritisation of a national suite of Quality Care Metrics (QCM), and their associated indicators, for midwifery care processes in Ireland.

Methods

The study involved four discrete, yet complimentary, phases; i) a systematic literature review to identify midwifery care process metrics and their associated measurement indicators; ii) a two-round, online Delphi survey of midwives to develop consensus on the set of midwifery care process metrics to be measured; iii) a two-round online Delphi survey of midwives to develop consensus on the indicators that will be used to measure prioritised metrics; and iv) a face-to-face consensus meeting with midwives to review the findings and achieve consensus on the final suite of metrics and indicators.

Results

Following the consensus meeting, 18 metrics and 93 indicators were prioritised for inclusion in the suite of QCM Midwifery Metrics. These metrics span the pregnancy, birth and postpartum periods.

Conclusion

The development of this suite of process metrics and indicators for midwifery care provides an opportunity for measuring the safety and quality of midwifery care in Ireland and for adapting internationally. This initial work should be followed by a rigorous evaluation of the impact of the new suite of metrics on midwifery care processes.
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Literature
1.
Maben J, Morrow E, Ball J, Robert G, Griffiths P. High quality care metrics for nursing: National Nursing Research Unit, King’s College London; 2012.
2.
Smith V, Begley C, Gross MM, Devane D. Chapter 3: Core outcomes in maternity care research (pp 55–72). In: Church S, Frith L, Balaam MC, Berg M, Smith V, van der Walt C, Downe S, van Teijlingen E, editors. New thinking on improving maternity care: International perspectives. London: Pinter and Martin Ltd; 2017.
3.
Powell Kennedy H, Shannon MT, Chuahorm U, Karavetz MK. The landscape of caring for women: a narrative study of midwifery practice. J Midwifery Womens Health. 2004;49(1):14–23.
4.
5.
6.
7.
Hsu CC, Sandford BA. The Delphi technique: making sense of consensus. Pract Assess Res Eval. 2007;12(10):1–8.
8.
Brennan RA, Callaway S. Innovations in practice: supporting the breastfeeding dyad in Labor & Delivery. J Obstet Gynecol Neonatal Nurs. 2014;43(1):S62–3.CrossRef
9.
Brown MJ, Sinclair M, Hill AJ, Stockdale J. Motivating pregnant women to eat healthily and engage in physical activity for weight management: an exploration of routine midwife instruction. Evid Based Midwif. 2013;11(4):120–7.
10.
De Bruin-Kooistra M, Amelink-Verburg MP, Buitendijk SE, Wester GP. Finding the right indicators for assessing quality of midwifery care. Int J Qual Health Care. 2012;24(3):301–10.CrossRef
11.
Gephart SM, McGrath JM, Effken JA. Failure to Rescue in Neonatal Care. J Perinatal Neonat Nurs. 2011;25(3):275–82.CrossRef
12.
Grier G, Geraghty S. Intimate partner violence and pregnancy: how midwives can listen to silenced women. Br J Midwifery. 2015;23(6):412–6.CrossRef
13.
Haines HM, Baker J, Marshall D. Continuity of midwifery care for rural women through caseload group practice: delivering for almost 20 years. Aust J Rural Health. 2015;23:339–45.CrossRef
14.
Hatten-Masterson SJ, Griffiths ML. Shared maternity care: enhancing clinical communication in a private maternity hospital setting. Med J Aust. 2009;190(11 Suppl):S150–1.PubMed
15.
Hodnett ED, Stremler R, Willian AR, Weston JA, Lowe NK, Simpson KR, Fraser WD, Gafni A. Effect on birth outcomes of a formalised approach to care in hospital labour assessment units: international, randomised controlled trial. BMJ. 2008;337:a1021.CrossRef
16.
Homer CSE. Models of maternity care: evidence for midwifery continuity of care. MJA. 2016;205(8):370–4.PubMed
17.
Jallo N, Bray K, Philpotts Padden M, Levin D. A nurse-driven quality improvement program to improve perinatal outcomes. J Perinat Neonat Nus. 2009;23:241–50.CrossRef
18.
Lucas MTB, Rocha MJF, Costa KMM, Oliveria GG. Nursing care during labor in a model maternity unit: cross sectional study. Online Brazalian J Nurs. 2015;14(1):32–40.
19.
An Bord Altranais. Guidance to nurses and midwives on medication management. Dublin: An Bord Altranais; 2007.
20.
Becker G. Baby friendly hospital Ireland (BFHI) audit tool for step 4; 2015.
21.
Department of Health. Communication (clinical handover) in maternity services National Clinical Guideline no. 5. Dublin: Department of Health; 2014.
22.
Department of Health. The Irish Maternity Early Warning System (IMEWS) National Clinical Guideline No. 4. Dublin: Department of Health; 2014. p. 2014.
23.
Department of Health. National Maternity Strategy: creating a better future together 2016–2026. Dublin: Department of Health; 2016.
24.
Faculty of Paediatrics and Health Service Executive. Pulse oximetry testing for newborn CHD: clinical care pathway.
25.
Health information and quality authority. Draft National Standards for safer better maternity services. Dublin: Health Information and Quality Authority; 2016.
26.
Health Service Executive. Code of Practice for Healthcare Records Management. Dublin: Health Service Executive; 2010.
27.
Health Service Executive, Dublin West Public Health Nursing Department CHO 7. (2016) Guidelines for Care of Umbilical Cord Revision No. 2 Reference No. 15. Dublin: Health Service Executive; 2016.
28.
29.
Health Service Executive. National Policy for Nurse and Midwife Medicinal Product Prescribing in Primary, Community and Continuing Care. Office of the Nursing and Midwifery Services Directorate. Dublin: Health Service Executive; 2012.
30.
Health Service Executive. Integrated Care Guidance: A Practical Guide to Discharge and Transfer from Hospital. 2012, v2, p17, Health Service Executive, Dublin.
31.
Health Service Executive. The Specialist Perinatal Mental Health: Model of Care for Ireland. Dublin: Health Service Executive; 2017.
32.
Health Service Executive - Clinical Programme for Obstetrics and Gynaecology. Irish Maternity Indicator System (IMIS) Revised version 1.2. Dublin: Health Service Executive; 2017.
33.
Health Service Executive - Health Protection Surveillance Centre. Prevention of Intravascular Catheter-related Infection in Ireland SARI Prevention of Intravascular Catheter-related Infection Sub-Committee. Dublin: Health Service Executive; 2009, Updated February 2010.
34.
Health Service Executive. National Policy for Nurse and Midwife Medicinal Product Prescribing in Primary, Community and Continuing Care. Dublin: Health Service Executive; 2011.
35.
Health Service Executive. Breastfeeding Policy for Primary Care Teams and Community Healthcare Settings. Dublin: Health Service Executive; 2015.
36.
Health Service Executive. National Standards for Bereavement Care Following Pregnancy Loss and Perinatal Death, Version 1.15. Dublin: Health Service Executive; 2016.
37.
Health Service Executive. National Service Plan. Dublin: Health Service Executive; 2017.
38.
Health Service Executive. Draft Guideline for the Management of Shoulder Dystocia. (undated) Health Service Executive; Dublin.
39.
Health Service Executive. Draft Guideline on Record Keeping Home Birth Service. (undated), Health Service Executive; Dublin.
40.
Health Service Executive. Draft Guideline on the Management of Perineal Repair HSE Home Birth Service. (undated), Health Service Executive; Dublin.
41.
Health Service Executive. Draft Guideline on the Management of Postpartum Haemorrhage HSE Home Birth Service. (undated), Health Service Executive; Dublin.
42.
Health Service Executive. Draft Guideline on the Management of Water Birth HSE Home Birth Service. (undated), Health Service Executive; Dublin.
43.
Health Service Executive. Draft Policy and Procedure for Notification of Infants born under the HSE Home Birth Service to the National Newborn Hearing Screening Programme. (undated), Health Service Executive; Dublin.
44.
Health Service Executive. Draft Policy and Procedure on the Administration of Vitamin K (Konakion MM Paediatric) Prophylaxis for Newborn Infants Health Service Executive Home Birth Service. (undated), Health Service Executive; Dublin.
45.
Health Service Executive. Draft policy and procedure to support the SECM with the transfer of women and/ or babies from home to hospital maternity services. (undated), Health Service Executive; Dublin.
46.
Health Service Executive. Draft Self Employed Community Midwives Midwifery Practice Guidelines HSE Home Birth Service. (undated), Health Service Executive; Dublin.
47.
Health Service Executive-Mayo General Hospital. Nursing Metrics in Mayo General Hospital. Dublin: Health Service Executive; 2012.
48.
Institute of Obstetricians and Gynaecologists and Health Service Executive. Antenatal routine enquiry regarding violence in the home. Clinical practice guideline: Dublin. Dublin: Health service executive; 2012.
49.
Institute of Obstetricians and Gynaecologists, Health Service Executive & Irish Haematology Society (2013) Venous thromboprophylaxis in pregnancy. Clinical practice guideline. Dublin: Institute of Obstetricians and Gynaecologists and Health Service Dublin; 2013.
50.
The National Institute for health and care excellence. Antenatal care for uncomplicated pregnancies, Clinical guideline [CG62]. London: NICE; 2008.
51.
The National Institute for Health and Care Excellence. Intrapartum care: care of healthy women and their babies during childbirth, clinical guideline 190. London: NICE; 2014.
52.
Nursing and Midwifery Board of Ireland. Recording clinical practice: professional guidance. Dublin: NMBI; 2015.
53.
Nursing and Midwifery Board of Ireland. Practice standards for midwives. Dublin: NMBI; 2015.
54.
Health Protection Surveillance Centre. Guidelines for the prevention of catheter-associated urinary tract infection. Dublin: Health Protection Surveillance Centre; 2011.
55.
Institute of Obstetricians and Gynaecologists, Health Service Executive. Intrapartum Fetal Heart Rate Monitoring, Clinical Guideline 6. Dublin: Health Service Executive; 2012.
56.
Health Service Executive. Draft Irish maternity early warning system audit tool. Dublin: Health Service Executive; 2017.
57.
Health Service Executive. Standard operating procedure for nursing and midwifery quality care metrics data collection in midwifery services. Dublin: Health Service Executive; 2015.
58.
Flenady V, Wojcieszek AM, Fjeldheim I, Friberg IK, Nankabirwa V, Jani JV, Myhre S, Middleton P, Crowther C, Ellwood D, Tudehope D, Pattinson R, Ho J, Matthews J, Bermudez Ortega A, Venkateswaran M, Chou D, Say L, Mehl G, Frøen JF. eRegistries: indicators for the WHO essential interventions for reproductive, maternal, newborn and child health. BMC Pregnancy Childbirth. 2016;16(1):293.CrossRef
59.
60.
Metadata
Title
Identifying and prioritising midwifery care process metrics and indicators: a Delphi survey and stakeholder consensus process
Authors
Declan Devane
Nora Barrett
Anne Gallen
Mary Frances O’Reilly
Margaret Nadin
Gillian Conway
Linda Biesty
Valerie Smith
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Care
Published in
BMC Pregnancy and Childbirth / Issue 1/2019
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-019-2346-z

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