Project leads
Jane
Dale, Consultant Diabetologist, Russells Hall Hospital
Kate Morse, Specialist Midwife, Perinatal Institute.
Aim
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.
Methods
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.
Results
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.
Some respondents felt the information
in the notes was different to current
practice
within
their
unit.
b. Mothers
We received feedback from women who had
pre existing diabetes and women who developed
gestational diabetes.
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 idea.
Conclusions
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.
Acknowledgements
Firstly we would like to thank all
the women who participated in the pilot and completed
questionnaires.
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.
Kate Morse, Specialist Midwife, Perinatal Institute.
To view the presentation from Kate Morse click
here.
To view the presentation from Sally Clifford click
here.
