| Título: | Strategies for changing practices: Optimising perineal outcomes through participatory action research |
| Autores: |
Muda, S; Southern Cross University, Lismore, NSW. Fahy, K; Southern Cross University, Lismore, NSW. Hastie, C; Southern Cross University, Lismore, NSW. |
| Fecha: | 2013-10-13 |
| Publicador: | Hunter New England Local Health District |
| Fuente: |
Ver documento |
| Tipo: |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
| Tema: | Nursing; Midwifery; Perineal Trauma; Evidence Based Practice; Clinical Guidelines |
| Descripción: | Problem: Perineal trauma occurs in up to 70% of women following vaginal birth Perineal trauma has negative effects on women physically and physiologically (WHO, 2005; Albers & Borders, 2007). Question: How can midwifery practice be improved to optimise perineal outcomes for women in labour? Aims: To improve midwifery practice, so as to optimise perineal outcomes and minimise perineal trauma for birthing women. Method: Participatory action research was undertaken at Kuala Lumpur Hospital. Data collection involved were six individual interviews, four focus groups, twelve sessions of group meetings, staff survey, direct observation and reflective journal. Data were analysed using content analysis, thematic analysis and reflection. Findings: The reasons given as to why labour ward staff persists in non-evidence-based practices that cause perineal trauma are that many staff are resistant to change. The model of care is highly medicalised, and the staff are busy, with a high student turnover. The focus group results indicated the belief that perineal trauma rates could be reduced with better staff training and supervision, and the development and implementation of evidence-based clinical guidelines for midwifery practice in the labour ward. Thematic analysis of group meeting information highlighted the strategies, which participants believed can reduce the rates of perineal trauma: in particular, practice development, and new practice guidelines coupled with strong internal support. Extensive staff training was undertaken, and new midwifery practice guidelines were developed by the researcher in consultation with senior midwives. Conclusions: Change to midwifery practice in labour ward is possible if there is support from key players in the organisations, staff training is extensive and midwives are supported by evidence-based guidelines which have medical endorsement. References WHO, Facts and Figures from the World Health Report. 2005. Albers, L.L., & Borders, N. (2007). Minimizing genital tract trauma and related pain following spontaneous vaginal birth, Journal of Midwifery & Women's Health, 52(3). 246-53. |
| Idioma: | Inglés |