As a pregnancy charity, supporting midwives, we regularly hear from different trusts about what they are doing to improve practices or help drive down their stillbirth rate and so we thought we’d share their ideas with you.
Please contact us with your trust’s innovations so we can add them to this page to help more babies arrive safely.
Taunton and Somerset NHS Trust
Taunton and Somerset reduced their stillbirth rate by 35% within 21 months and by 50% within 3 years by implementing ALL elements of the NHS Saving Babies Lives Care Bundle. They started with the Sign Up To Safety campaign and receiving full support from their Clinical Director…….
We have a smoking cessation midwife for 3 days a week who meets with the Midwifery Matron every month to go through the figures. The aim is that all women have a CO breath test at the earliest opportunity. All women with a reading above 4 are referred to Stop Smoking Services. To ensure as many women as possible have a CO breath test all women who attend for Down’s syndrome screening are offered the test at this time. Since the introduction of this second intervention the % of women having an early CO breath test has improved to 81%. Still more work to do to get to a 100% though.
Smoking Cessation Midwife Sally Bryant, Midwife and Maternity Care Assistants pictured in the Combined Test Clinic:
All women with a positive CO breath test are referred to Stop Smoking Services. Since the introduction of ‘no opt out’ the number of referrals in has increased by 18% (126 more women have received support to quit).
For smoking mothers, cigarette stickers are fixed onto their GROW charts as an indicator that their smoking may impact on their baby’s growth. It is also a reminder to the health professional to discuss the benefits of quitting.
When mothers stop smoking, an “I’ve quit” sticker is placed over the top to celebrate their success.
Outside the maternity unit, a PA system speaker has been installed which plays a loud sound of a child’s voice This can be operated a distance away from the speaker, when a mother or visitor is smoking the child’s voice is triggered to deliver a reminder about the effects of smoking. There are seven different voices for the operator to choose from. Mothers have stated that when lighting up subsequent cigarettes at home, they could still hear the child’s voice, which helped them to give up.
Saving Babies Lives Study Days take place every month where data is shared and new practices are discussed. Whenever Musgrove Park suffers the loss of a baby, the whole maternity team is notified by email and given brief details of events surrounding the stillbirth.
The team are also kept updated through the investigation process, so that everyone learns from any lessons. There is also a large wooden heart displayed in a staff area that shows the number of days that have passed without a stillbirth. When 100 days is reached, the whole team celebrates together. This simple initiative has raised the profile of stillbirths throughout the unit.
Detecting Growth Restriction
Musgrove Park hasn’t implemented GAP fully. Undertaking serial scans (3 weekly) on all women at increased risk of having a baby with growth restriction (FGR) is a challenge for the service. Until there is more capacity the unit has taken a phased approach to implementing this element of the bundle with the provision of a minimum number of scans to women at increased risk of FGR. GAP was re-launched and the training was included within a specific study day for Midwives that covered all four elements of the Saving Babies Lives Care Bundle. After becoming an early implementer of the Care Bundle the number of stillborn babies has fallen. It is too early to day if this is sustainable, but importantly the number of stillborn babies who were small fell from 47% in 2014 to 14% in 2015. We also share and celebrate the inductions and deliveries that we get right (are found to be SGA after birth) rather than focus on the babies that weren’t SGA after delivery. We also print the MAMA Poster artwork on the back of the mothers GROW charts.
Every mother is given the NHS leaflet by the 24th week of pregnancy that raises awareness of baby movements and the importance of monitoring and reporting a change or reduction in movements. Monitoring of compliance is undertaken each week by screening the notes of women who attend for an anomaly scan appointment.
The team are more than happy to share any of the interventions, please contact us on:
Tel: 07979495324 Tel: 07776280066
Kingston Hospital NHS Trust
To notify others that a baby had a sibling who has died, the cots on the postnatal ward and neonatal unit are marked with purple Butterfly stickers to symbolise that the baby is part of a multiple pregnancy whereby the other sibling/s have sadly died.
Staff communicate, share ideas and learn together through the business social app that is Yammer. Colleagues can ask each other questions and share rotas around the clock which fits around their shift patterns. It’s completely free and very easy to use.
As a practising GP, Dr Vincent Forte consistently had problems in getting quality urine MSU specimens from patients from which he could diagnose their symptoms and accurately treat … and so designed a solution – the Peezy Midstream. Today, this simple innovation enables right-first-time specimen analysis, reduces the national average of 15- 30% contamination rate of the 65+ million samples collected every year using traditional methods down to as little as 3%-1.5%, and could conservatively save the NHS £30+ million every year.
The antenatal market accounts for around 5.5 million MSU specimens of which, based on current responses to a recent FOI request, 1.5 million may be contaminated. Given the frequency that expectant mothers have to take samples, Peezy Midstream can reduce the unnecessary need and expense of repeat specimens and testing – and allows greater peace of mind.
The device is ergonomically made to be easy to handle, reject the often contaminated first-flush urine into the toilet, capture and isolate midstream into the collection tub and direct overflow back into the toilet. It minimises contamination, eliminates any contact by the patient with the urine, and any soiling of surrounding area, container, label and hands. Research undertaken in association with Bounty as well as anecdotal feedback from users has shown that it is a welcome innovation, easy and hygienic to use
Peezy Midstream has gathered excellent evidence from patients, clinicians and microbiologists alike; it is in use across a number of NHS Trusts and is available to patients on prescription. One of the earlier studies from the Peninne Acute Hospitals NHS Trust testified to the efficiency and efficacy of the Peezy and this has subsequently been borne out by further research from Barts & The Royal London and the UCL School of Medicine.
Analysis of urine samples can be as clinically important as blood testing, but sampling standards are not always as stringent. There is no established protocol. As Giovanna Forte, CEO of Forte Medical and sister of Vincent, describes it: “Urine analysis is a vital diagnostic tool in many clinical areas and hit and miss collection is unacceptable. Sending a contaminated urine specimen to a laboratory is like asking a detective to solve a crime by looking through a dirty window”.
At a time when healthcare services are looking for innovation, cost savings and improving the environment of both patients and front-line healthcare works, exposure to cross infection, contaminated specimens and lack of dignity should hopefully soon become a thing of the past.
For further information or to request a sample, please visit www.forte-medical.co.uk, call 020 7300 7225 or email: firstname.lastname@example.org