The next SWARM backed project will be looking at the antenatal provision of written information on options for analgesia and anaesthesia during labour and delivery in the South West. This project, led by Dr. Lizzie Freeman, won at the SWARM Hive of Ideas in October 2022.
Background:
Women are frequently required to make rapid decisions during labour, often when in pain, fatigued, anxious and having received opiate analgesia or Entonox. All can contribute to difficult communication and comprehension of new information. Anaesthetists must gain informed consent prior to carrying out neuraxial procedures (epidurals, spinals and CSEs), which can be challenging for both patient and clinician if the information provided is unfamiliar.
Joint guidance from the OAA and AAGBI from 2013 states that ‘Up-to-date, locally relevant information about the services offered should be available for mothers in a range of formats appropriate to their needs’, usually antenatally [1]. This is also reflected in the RCoA GPAS guidance on provision of obstetric anaesthetic services (Chapter 9) and the AAGBI guidance on consent (2017), which state that ‘every unit should provide, in early pregnancy, advice about pain relief and anaesthesia during labour and delivery. An anaesthetist should be involved in preparing this information and should approve the final version.
Project Aims:
- Assess the current provision of antenatal information on analgesic and anaesthetic options for labour and delivery in the South West peninsula region.
- Evaluate maternal attitudes towards antenatal information on analgesia/anaesthesia and its impact on expectations, maternal experience and satisfaction.
- Using Public and Patient Involvement (PPI) and in collaboration with the Devon Maternity Voices Partnership, develop new resources in line with AAGBI/OAA guidance.
Project Timeline
May 2023: We undertook a trainee led survey of postnatal women at Derriford Hospital. Data was collected over a 24 hour period, during which time all postnatal women meeting inclusion criteria will be identified and offered the survey to complete. This data was used to will validate the study protocol prior to proceeding with the region wide survey.
August 2023: The region wide survey was performed using the finalised protocol.
Autumn 2023 onwards: Data will be analysed using quantitative methods, comparing the provision of information to national guidelines. A patient focus group (recruited via the Devon Maternity Voices Partnership) will assist with our analysis of the survey results in order to draw conclusions and inform the development of new resources.
These resources will be introduced at Derriford and shared with other sites, subject to necessary approvals.
We will aim to repeat the survey at any sites adopting the new resource. The Newcastle PROMs text follow-up system can be used at Derriford to measure change over time.
For more information or if you would like to get involved, please contact your local lead or the project lead Dr. Lizzie Freeman at Lizzie.freeman@nhs.net
Local leads
Derriford – Tak Chan
Torbay - Rebecca Allott
Exeter - Laura Markham
Taunton - Timothy Richards
Truro – Sarah Cassie
Barnstaple - Edward Cope