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Incorporating the views of obstetric clinicians in implementing evidence-supported labour and delivery suite ward
Neelima Deshpande1, Mary Publicover, Harry Gee
1Birmingham Women's Health Care NHS Trust, Birmingham, UK.
Objectives:
To implement evidence-supported delivery suite ward rounds using strategies to overcome barriers.
Design:
Qualitative case study to identify barriers and a quantitative assessment of outcomes on ward rounds.
Method:
After an introduction to the proposed evidence-supported delivery suite ward round reactions were elicited from 15 clinicians. Responses were categorized into barriers related to knowledge, skills, attitudes and behaviour. Using strategies to overcome these barriers, a weekly evidence-supported ward round was established. During patient-centred discussions, clinical questions were formulated. Following literature searches, evidence was acquired and appraised.
Results:
Clinicians had limited awareness about the potential benefits of a clinical librarian's support during ward rounds. They were unsure of their skills in evidence-based practice. There was scepticism, fear of loss of autonomy, poor motivation and resistance to change. Clinicians identified several factors that could impinge on their practice. Using appropriate strategies when evidence-supported ward rounds were conducted, 67 questions were raised. However only seven articles were appraised in time to affect decisions on that ward round.
Conclusions:
Knowledge of barriers was helpful in developing plans for implementation of evidence-supported ward rounds. The pilot study indicates the feasibility of this approach.