An Evaluation of the Midwifery Development Unit Service Specifications, Through the Quality Assurance Model for Midwifery

Nursing, Obstetrics

Holmes, Elizabeth Ann

University:University of Glasgow

关键词: Nursing, Obstetrics;   

Others  :  http://theses.gla.ac.uk/75797/1/13818533.pdf

来源: University of Glasgow

【 摘 要 】

The United Kingdom's first Midwifery Development Unit was established at Glasgow Royal Maternity Hospital in July 1992. This is a large university teaching hospital with around 5000 deliveries per annum which serves a relatively disadvantaged population (McGinley, Turnbull, Fyvie, Johnstone & MacLennan, 1995). The aim of the Unit was to improve the quality of care provided to women during pregnancy and childbirth. The Unit's objectives were to: introduce a midwifery care programme for healthy pregnant women; encourage participating midwives to utilise their skills to the full; monitor and evaluate the unit; and develop audit and educational tools for use by the profession and other health boards. The Midwifery Development Unit consisted of a midwifery and a research team, overseen by a multidisciplinary steering group. The research team was responsible for evaluating the new midwifery care programme using a randomised controlled trial which compared the clinical, psychosocial and economic outcomes of 648 women randomised to receive midwife-managed care, with 651 women randomised to receive shared care (Midwifery Development Unit, 1995a).The midwifery team developed the midwife-managed programme of care using a consumer driven Quality Assurance Model for Midwifery - QAMID (World Health Organisation, 1991; McGinley et al, 1995). Through QAMID, three seirvice specifications were generated which described the goals of the new programme and encompassed: Continuity of carer: women would be cared for by a named midwife and three associate midwives, from booking through to transfer to the health visitor in the postnatal period Individual informed care planning: each woman would hold her own Care Plan which would contain clinical notes, as well as her preferences for care and her comments on care following a debriefing session Information and choice: each woman would receive a basic Information Pack with information tailored thereafter to the woman's needs. In addition to the randomised controlled trial, a study was carried out to identify how well these service specifications were achieved. The specific objectives of the study were: to identify how many women received a Care Plan and basic Information Pack; to ascertain the number of midwives who cared for each woman; and to measure women's satisfaction with the delivery of care in relation to the service specifications.