Obstetric anal sphincter injuries Pregnancy and Childbirth
Conditions
Interventions
Great Britain (England, Wales and Scotland but not Northern Ireland) was divided into four geographical blocks. Within each region, four maternity units of different type and size were selected to obt
Sponsors
Royal College of Obstetricians and Gynaecologists (RCOG)
Eligibility
Sex/Gender
Female
Inclusion criteria
Inclusion criteria: All vaginal births are eligible for the intervention when the attending clinician (midwife or obstetrician) has been trained to use the OASI Care Bundle
Exclusion criteria
Exclusion criteria: Women are excluded if they are in a birthing position (e.g. water birth) that makes it impossible to implement all aspects of the OASI Care Bundle
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Rate of obstetric anal sphincter injuries (OASI), assessed via routinely collected patient-level data, captured through each unit’s maternity information system (MIS) over an 18-month period | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Acceptability (satisfaction with the intervention) will be measured using: 1.1. The Organisational Readiness for Implementing Change (ORIC) scale will assess the unit’s commitment to change. This questionnaire will be completed by all champions prior to roll-out (January 2017, April 2017, July 2017 and September 2017) 1.2. Focus groups with clinicians at the maternity units will explore individual attitudes towards the care bundle, training and the awareness campaign. These discussions will be held six weeks after the start of roll-out in each unit (March 2017, June 2017, August 2017 and December 2017) 1.3. Focus groups with the champions from each maternity unit will explore the attitudes of staff within the unit towards the care bundle and what drove this reaction. These discussions will be held at the end of the three month ‘transition’ phase (April 2017, July 2017, September 2017 and January 2018) 1.4. Interviews with women who have experienced the care bundle will explore appropriateness and views of the intervention. These will be conducted six months after the start of roll out within each unit (July 2017, October 2017, January 2018 and March 2018) 2. Feasibility (extent to which intervention can be applied) will be measured using: 2.1. The Organisational Readiness for Implementing Change (ORIC) scale will assess collective commitment to change. This questionnaire will be completed by all clinicians at the maternity units who participate in the focus group discussions (March 2017, June 2017, August 2017 and December 2017) 2.2. Focus groups with clinicians at the maternity units will explore individual views on the ‘train the trainer’ approach, main issues with the care bundle and perceived women’s attitudes towards it. These discussions will be held six weeks after the start of roll-out in each unit (March 2017, June 2017, August 2017 and Decemb | — |
Countries
United Kingdom
Contacts
Public ContactAlexandra Hellyer
Outcome results
None listed