NHS临床指南 PROMOTING NORMALITY A woman centred approach to maternity care.PPT.ppt

* * * * * * * * * * * * * * * PROMOTING NORMALITYA WOMAN CENTRED APPROACH TO MATERNITY CARE. by Amanda Lucas Matron Maternity Services/ Supervisor of Midwives EAST CHESHIRE TRUST WHY PROMOTE NORMALITY? DH documents (1993, 2004 2007) advised woman centred approach, access to high quality maternity services and choice, access and continuity of care for all women Other drivers for normality include documents from the NCT (2007 2010) which suggest the normal birth rate could be used as an indicator of quality in midwifery care NICE Intrapartum guidance promotes intervention only when necessary High Impact Actions (NHS Institute for Innovation Improvement, 2010) has a focus on promoting normal birth and reducing the caesarean section rate CMACE report 2006-2008 Saving Mother’s Lives advises a back to basics approach with teamwork and improved communication IN REAL TERMS…… FROM A QUALITY PERSPECTIVE Women are more likely to feel in control requiring less pharmacological analgesia (Hildingson et al, 2003) Women are more likely to breastfeed (Hatem et al, 2008) Better outcomes for mothers and babies (Wagner, 2002; Johanson et al, 2002 Edwards Byrom, 2007) Women have the choice of place of delivery The midwife will be the lead professional, continuity of carer, holistic care Increased job satisfaction for midwives FINANCIAL IMPLICATIONS Reduction in cost pressures (Newburn Singh, 2003) Reduced length of stay in hospital (￡2630 BY 1 DAY) Reduced medical staffing post operative nursing costs (￡820 per case NHS INSTITUTE FOR INNOVATION IMPROVEMENT) Less outlay on medical equipment as midwives utilise clinical skills Possible financial bonus when targets met (locally agreed) Possible financial penalties when targets not met (locally agreed) CHALLENGES TO NORMALITY AT ECT Previously medically dominated Midwives de-skilled and reliant on obstetricians Increased intervention due to the fear of litigation Negative publicity and the ethos of “too posh to push” A