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BMC Health Services Research
Published in: BMC Health Services Research 1/2018

Open Access 01-12-2018 | Research article

Change in practice: a qualitative exploration of midwives’ and doctors’ views about the introduction of STan monitoring in an Australian hospital

Authors: M. E. Mayes, C. Wilkinson, S. Kuah, G. Matthews, D. Turnbull

Published in: BMC Health Services Research | Issue 1/2018

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Abstract

Background

The present study examines the introduction of an innovation in intrapartum foetal monitoring practice in Australia. ST-Analysis (STan) is a technology that adds information to conventional fetal monitoring (cardiotocography) during labour, with the aim of reducing unnecessary obstetric intervention. Adoption of this technology has been controversial amongst obstetricians and midwives, particularly as its use necessitates a more invasive means of monitoring (a scalp clip), compared to external monitoring from cardiotocography alone. If adoption of this technology is going to be successful, then understanding staff opinions about the implementation of STan in an Australian setting is an important issue for maternity care providers and policy makers.

Methods

Using a maximum variation purposive sampling method, 18 interviews were conducted with 10 midwives and 8 doctors from the Women’s and Children’s Hospital, South Australia to explore views about the introduction of the new technology. The data were analysed using Framework Analysis.

Results

Midwives and doctors indicated four important areas of consideration when introducing STan: 1) philosophy of care; 2) the implementation process including training and education; 3) the existence of research evidence; and 4) attitudes towards the new technology. Views were expressed about the management of change process, the fit of the new technology within the current models of care, the need for ongoing training and the importance of having local evidence.

Conclusions

These findings, coupled with the general literature about introducing innovation and change, can be used by other centres looking to introduce STan technology.
Appendix
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Footnotes
1
At the time of the study, STan was not supported in Australian guidelines.
 
2
After the current study was completed an RCT was published regarding the US population who have a similarly high caesarean section rate of 30% [19, 33]. However, the two settings are not directly comparable as the model of care differs with the US having minimal Midwife driven care [34].The STan method was found to produce insignificant differences in caesarean section outcomes compared with standard CTG [34].
 
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Metadata
Title
Change in practice: a qualitative exploration of midwives’ and doctors’ views about the introduction of STan monitoring in an Australian hospital
Authors
M. E. Mayes
C. Wilkinson
S. Kuah
G. Matthews
D. Turnbull
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2018
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-018-2920-5

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