This evaluation was a joint project between, the Perinatal Institute and 5 local
Russells Hall Hospital
Birmingham Heartlands Hospital Birmingham Women’s
Queen’s Hospital Burton
University Hospitals of Coventry and Warwickshire
The findings of which were presented at a regional meeting in June 2008.
Jane Dale, Consultant Diabetologist, Russells Hall Hospital.
Kate Morse, Specialist Midwife, Perinatal Institute.
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.
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.
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.
We received feedback from women who had pre existing diabetes and women who developed
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
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.
Firstly we would like to thank all the women who participated in the pilot and completed
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.