Postnatal Notes Field Trial
This evaluation was a joint project between
the Perinatal Institute and the Mid-Staffs
NHS Trust, Maternity Department of Stafford
District General Hospital and community
areas of Rugeley and Cannock.
Aim
The aim of the field trial was to assess
the 'user friendliness' of the new Postnatal
Notes for Mother and Baby, for both mothers
and health professionals.
Methods
50 sets of notes were audited, 50 mother
and 50 baby of the first 50 consecutive
women to deliver a live baby booked by
the Chase Team from commencement of the
evaluation. 80 midwives altogether used
the documentation, 67 hospital based midwives
and 13 community based midwives.
Feedback from Midwives
33% of the midwives who used the Notes responded
to the questionnaire.
Delivery suite midwives – Initially
they found the notes time consuming and some
sections repetitive. They found that the
birth summary and postnatal checks were good,
but would find navigation easier if they
were on the front page. The tick boxes in
these sections were not popular as the midwives
preferred to make notes. In the ‘Information
for Mothers’ section, they liked the
documentation on mothers’ emotions
but felt they did not and would not get a
positive response to the section on contraception.
In the ‘Examination of the Newborn’ section
they did not have enough space to document
abnormalities. They also felt that 10 days
was not long enough for mothers to read through
the information.
Team Co-ordinator, Community – The
team felt they had to navigate through the
notes to find the information they were looking
for. When completing the postnatal discussion
some mothers used the opportunity to complain
about waiting times and meals etc and this
then created more problems. The postnatal
checks were not consecutive which meant flicking
through the notes. There was positive feedback
on the breastfeeding information and the
idea of both the GP and health visitor having
a copy of the discharge letter, although
this could also be time consuming. Overall
they would prefer one set of notes and the
mothers to keep the information sections.
Community Midwife – The community
midwives found that the notes were initially
time consuming but became better with experience.
They liked the information within the notes
and thought that it would be good for fathers
to read and know what was going on. Space
to document what advice and information they
give the mothers, to allow effective communication
of information to other carers would have
been preferred.
Mothers
The majority of the mothers wanted a ‘great
deal’ or ‘quite a lot’ of
information during the postnatal period.
80% of the mothers read the information in
the notes and all understood
the content
and were happy with the amount of detail.
They all thought the information given was
relevant, with some wanting more information
in certain areas, especially neonatal screening.
Conclusions
The field trial of the Postnatal Notes demonstrated
that they improved with use and highlighted
areas of concern. The mothers found them
informative and easy to understand. The
health professionals thought they were
repetitive and thought that the mothers
would not have time to read them. The main
challenge appears to be improving familiarity
with the layout of the notes which should
be achieved with adequate training and
use.
Acknowledgements
We would firstly like to thank
the women who agreed to participate in the
use of
the notes during the postnatal period
and completed
questionnaires to aid our evaluation.
We are also grateful to the hospital midwives
of the Stafford District General hospital
and community midwives of the Chase Team,
Cannock, for their participation and
cooperation in the field trial of the Notes;
in particular
Joyce Till and Diana Websdale, who coordinated
the evaluation locally; and Gerry Vaz
and Kate Tomlinson for presenting the
findings of the evaluation at a regional
forum.
Finally, we would like to thank Gill
Landon, Head
of Midwifery, and Wendy Hayes, Community
Midwifery Manager for agreeing to participate
in the project.
