Implementation of gestational weight gain guidelines - what’s more effective for ensuring weight recording in pregnancy?

BMC Pregnancy and Childbirth

Shelley Wilkinson¹  Elin Donaldson¹  Sally McCray¹  Michael Beckmann² 

[1] Department of Dietetics and Foodservices, Mater Health;Mater Research Institute – University of Queensland, Mothers, Babies and Women’s Theme;

关键词: Antenatal;    Weight recording;    Guidelines;    Implementation;    Translation;   

DOI  :  10.1186/s12884-018-2162-x

来源: DOAJ

【 摘 要 】

Abstract Background Pregnant women who gain weight in accordance with guidelines have the lowest risk of pregnancy and birth-related complications. However, evidence-practice gaps often exist. To address pregnancy weight management barriers, a stepped implementation science approach was used, comprising targeted in-services, provision of scales for clinic rooms, and changes to routine weight recording in a hospital electronic medical record. The aim of this study was to assess the cumulative influence of evidence-based interventions on staff’s compliance to recording of antenatal weights. Methods Retrospective data analysis of weight recording over three 15-month cohorts across April 2014–December 2017. Variables calculated from data included: proportion of women with weight recorded at booking and proportion of women who had a weight recorded at each visit. Generalised estimating equation modelling was used to examine differences in weight recording compliance rates between cohorts, pre-pregnancy body mass index categories, model of care and clinicians. Results There were approximately 13,000 pregnancies in each cohort. The proportion of women who had a weight recorded at each visit per cohort differed significantly between cohorts from 4.2% (baseline), 18.9% (scales and in-services) to 61.8% (medical record prompts), p < 0.001. Conclusion Significant improvements were achieved through systematic barrier analysis and subsequent mapping and implementation of appropriate and effective interventions. Improvements were observed across the entire service, in all models of care with all professional groups demonstrating increased recording of weights.

【 授权许可】

Unknown