About the Birth Notes Diabetes in Pregnancy Notes
Results of the Field Trial
 
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This evaluation was a joint project between, the Perinatal Institute and 5 local units:

Russells Hall Hospital

Birmingham Heartlands Hospital

Birmingham Women’s Hospital

Queen’s Hospital Burton

University Hospitals of Coventry and Warwickshire

The findings of which were presented at a regional meeting in June 2008.

Project leads

Jane Dale, Consultant Diabetologist, Russells Hall Hospital.
Kate Morse, Specialist Midwife, Perinatal Institute.

Aim

The aim of the field trial was to assess the ‘user friendliness’ of the notes and whether the notes fulfilled the role they were intended to, i.e. clear, logical documentation of diabetes during pregnancy.

Methods

The trial started in November 2007.

75 sets of notes were issued, 15 to each site. The notes were issued to women who had either pre-existing or gestational diabetes, on their first appointment to a dual antenatal/diabetes clinic. The notes are intended to be used in conjunction with the Pregnancy Notes. It was anticipated the trial would take approximately 8 months to complete to ensure the notes where used for the duration of the pregnancy and at the postnatal follow-up appointment. However, if longer was required to ensure a sufficient quantity of notes were used this was acceptable.

Each unit was issued with a supply of evaluation forms for health professionals. The purpose of these forms was to ascertain feedback from clinicians on the layout, progression and usefulness of the document for recording the care provision. This enabled them to provide feedback and make suggestions about changes they would like to see made to the document.

Each set of notes included an evaluation form for the expectant mother to complete, to comment on the information included in the document.

Results

a. Health Professionals

Feedback was received from Diabetologists, Obstetricians, Midwives, Dietitians, Diabetes Nurse Specialists and Specialist Midwives and all the units who took part in the trial provided comments. The majority of the feedback was positive, most staff felt the notes were clear, displayed logical progression and they felt the information for women was appropriate. Other staff felt unsure at first, but commented that they thought the navigation through the notes would improve with familiarity.

There were comments about being unsure as to who writes in which booklet and there was also a concern that there was duplication of documentation between this booklet and the hospital records.

There were a couple of comments about the quality of paper used; it was felt it was not substantial enough to withstand being written in daily, if issued early in the pregnancy.

Somerespondents felt the information in the notes was different to current practice within their unit.

b. Mothers

We received feedback from women who had pre existing diabetes and women who developed gestational diabetes.

  • The age range of the respondents was: 27 years – 45 years

  • 50% of the women were expecting their first baby

  • The gestation when notes issued varied from 8 weeks - 37 weeks

  • The women who responded to the evaluation were from a variety of ethnicities including: European, Indian, Pakistani, South East Asian and Arabic.

All of the women wanted information about diabetes during pregnancy and were happy with the amount of detail in the notes. All of them had read some to all of the information. They all thought the information given was relevant, not difficult to read and was easy to understand. All the women thought the notes were a good idea.

Conclusions

The field trial of the notes was successful. It allowed us to confirm that the notes will fulfil the role they are intended for. It gave invaluable feedback to develop and improve the notes further. The result from the feedback confirms the need for adequate training of professionals prior to use, to aid implementation and familiarity of the document.

Acknowledgements

Firstly we would like to thank all the women who participated in the pilot and completed questionnaires.

We would also like to thank all the health professionals who took part in the field trial, not only using the notes to record the care they gave but also taking time to complete the evaluation forms.

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