Innovative training to improve the safety of women and babies in low risk labour developed in the Thames Valley has won a national award. The initiative won the Patient Safety Innovation of the Year category at the HSJ Patient Safety Awards. It was also highly commended in the Education and Training category. The practical online programme is the first to integrate real fetal heart sounds, making it more realistic for midwives and helping them to differentiate normal and abnormal heartbeats in the womb. This approach, known as intelligent intermittent auscultation (IIA), will benefit tens of thousands of low-risk pregnant women across the country who receive midwife-led care every year – approximately one in three pregnancies.
The free programme was developed by the Oxford Academic Health Science Network with consultant midwives Christine Harding (Royal Berkshire Hospital, Reading) and Wendy Randall (Oxford University Hospitals) with valuable input from the OxSTaR Centre, the University of Oxford’s medical simulation, research and teaching facility.
Eileen Dudley, Patient Safety Manager at the Oxford AHSN, said: “We are absolutely delighted that the importance and quality of this work has been recognised on a national scale.” Christine Harding said: “I am absolutely thrilled with this success. We believe improving the accuracy of intelligent intermittent auscultation is vital for keeping mothers and babies safe so being recognised by the HSJ Patient Safety Awards is just fantastic.” Wendy Randall said: “Christine and I are delighted with the recognition this project has received. We feel that the education and assessment that it offers enables more consistent and safer practice in assessing fetal wellbeing in labour.”
Since its launch in January 2020, more than 3,000 people have accessed the IIA training package. The first supporting webinar created by the Oxford AHSN has had around 700 views on YouTube and a short introductory video has been seen almost 7,000 times.
Eileen added: “This is a fantastic example of how the sharing of ideas, knowledge and resource can bring improvements in patient safety. By creating local solutions and being willing to share these, the team has proved that you can have a positive impact on national patient safety in a relatively short space of time.”
The training has been available to all midwives in England through the Health Education England e-LfH (e-Learning for Healthcare) platform since January this year. Mandy Platt, Lead Midwife for clinical quality and service improvement at Tameside and Glossop Integrated Care NHS Foundation Trust, said: “Finally midwives now have access to a national training platform for fetal monitoring in a low risk setting. I feel the standard of training is excellent and (will) no doubt improve outcomes for babies but also confidence for midwives providing intrapartum care in low risk settings.”
IIA is the recommended method of monitoring the heart rates of babies in the womb during low risk labour. It is a practical skill required of all midwives in any birth setting. The training enables midwives to make an intelligent assessment of how the baby is coping with the stress of contractions based on what they are hearing and take the appropriate next steps to ensure safe care.
Eileen said: “The most important aspect of this programme is that improved midwifery knowledge and accuracy in intermittent auscultation means that low risk women and babies receive high quality safe care to ensure the best possible outcome for their labour and birth. This unique programme will standardise the teaching and assessment of competency of intermittent auscultation and lead to improvements in the accuracy of this midwifery skill, patient safety and perinatal outcomes.
“This is the only training package that assesses competency in intermittent auscultation to meet the requirements of the Saving Babies’ Lives version 2 care bundle for reducing perinatal mortality. Improving knowledge and skills improves safety for mother and baby by ensuring midwives are better able to identify abnormalities in the fetal heart rate pattern and/or changes in the mother’s level of risk and take prompt action.”
This initiative has already received national recognition including winning the Contribution to Midwifery Education at The British Journal of Midwifery Practice Awards and judged the top poster submission at the National Maternity and Perinatal Audit/Each Baby Counts conference, both in 2019.