Assessing women with symptoms of threatened preterm labour: a service proposal
Approximately 8% of all UK births occur preterm, resulting in increased neonatal mortality and significant disability, while causing a financial burden for the NHS. This proposal outlines how an app could be incorporated into the assessment of women presenting with symptoms of threatened preterm labour, to assist with early recognition and optimise neonatal outcomes. Lewin's change model was used to plan this service improvement and a planning triangle and action planning tool were used to assist with implementation and stakeholder engagement. Data from the trust show that implementation of the app could decrease admissions and reduce unnecessary interventions, providing a significant cost saving for the trust. This proposal also reviewed the leadership skills required for staff engagement. Pre-change data demonstrate that implementation of this app could have potentially improved the care of 89 women in the trust in one year.
This article describes a proposed change to the assessment of women who attend local maternity services with symptoms of threatened preterm labour. Preterm births account for approximately 8% of UK births nationally (NHS Digital, 2019), affecting approximately 60 000 (Office for National Statistics, 2017) families who have babies born with higher risks of neonatal mortality, and significant disability. Morbidity is directly correlated to gestational age, with the most significant adverse outcomes occurring in births less than 32+0 weeks gestation (UK Preterm Clinical Network, 2019). Preterm births cost health services in England and Wales approximately £3.4bn per year (National Institute for Health and Care Excellence (NICE), 2015), and over the last 10 years, there has been no decline in the preterm birth rate (NICE, 2019).
The national maternity safety ambition is to halve the rates of stillbirths, neonatal and maternal deaths and brain injuries that occur during or soon after birth by 2030 (Department of Health, 2016). It has been recognised that there must be a reduction in preterm births to achieve this. The Department of Health (2016) have set an ambition to reduce preterm births from 8% to 6%, by 2025. In line with this, the author's trust's quality accounts report supports the recommendations from the Ockenden (2020) report, which highlight the saving babies lives care bundle as a priority in local maternity services (County Durham and Darlington NHS Foundation Trust (CDDFT), 2021).
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