Hospital postnatal discharge and sepsis advice: Perspectives of women and midwifery students
Women are discharged home from hospital increasingly early, but there is little evidence examining the postnatal hospital discharge process and how this may impact on the health of women and babies. In particular, there is little on sepsis prevention advice, despite it being the biggest direct cause of maternal mortality.
To explore the perceptions of women and senior student midwives related to the postnatal hospital discharge process and maternal sepsis prevention advice.
Three focus group interviews were undertaken, involving 9 senior student midwives and 14 women attending paid or specialist classes for vulnerable migrant women.
All participants believed that the postnatal hospital discharge process was inadequate, rushed and inconsistent. Sepsis advice was patchy and the condition underplayed.
Cost effective, time-efficient and innovative ways to impart vital information are required to support the postnatal hospital discharge process.
The length of the postnatal hospital stay has fallen over the past 30 years, with pressure on health services to reduce this further (Bowers and Cheyne, 2016). With the emphasis on enhanced recovery, many women are now discharged home within 24 hours of giving birth, even after caesarean section (World Health Organization (WHO), 2013). Shortened hospital stays in the postnatal period have implications for maternal and neonatal outcomes; therefore good quality postnatal care is essential.
Surveys have found dissatisfaction with the provision of postnatal care, both among mothers and midwives (Bhavnani and Newburn, 2010; Royal College of Midwives (RCM), 2013; WHO, 2013). Midwives report particular challenges, including a lack of time at the postnatal hospital discharge to impart vital health information, such as hand hygiene and maintaining maternal wellbeing (RCM, 2013). The National Institute for Health and Care Excellence (NICE) (2013) outlines the myriad of information that mothers should receive at the first postnatal contact, and the postnatal hospital discharge requires women to have received this vital public health information and tailored advice (NICE, 2013). In addition, language barriers could further compound communication difficulties in women with low levels of spoken English. Evidence suggests that trained interpreters are not consistently used in maternity services (Haith-Cooper, 2014; Phillimore, 2015).
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