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Quality at CM Health

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recommended that “Immediate consideration needs to be given to ways of making contraception much more accessible, affordable and available to women in the CMDHB region.” In response to this recommendation a working group was established with wide representation from the various health care professionals. Initially the group documented a woman’s journey, in diagram form, from high school through to the completion of her family to inform possible access to contraception to inform their work-plan. What have we done to improve women’s access to contraception? • Survey of women on the maternity wards. This survey was undertaken to understand our women’s experience and knowledge of contraception and whether their babies were planned. Of the 247 women surveyed, 198 (80%) said that they had had at least one unplanned pregnancy. • Survey of CM Health staff on the maternity ward. This survey was undertaken to better understand staff’s knowledge and confidence of discussing contraception with women. This identified a number of staff who had little or no knowledge about different types of contraception and they were not confident to prescribe. • An education and training package was developed based on the Family Planning Association’s resources but tailored to postnatal contraception. This was made available for

all midwives (employed and self-employed)and nurses. This included flow charts on how to prescribe, administer and organise the different methods of contraception. Almost 200 staff members were trained and repeat surveys showed an increase in knowledge and confidence. A trial of group contraception sessions for post-partum women was undertaken on the postnatal ward but was poorly attended. Feedback indicated women were not comfortable discussing these issues in a group situation. To ensure women’s privacy and in respect of the culturally sensitive and personal nature of this topic an information pamphlet was developed to provide a discussion aid to cover all options of contraception when individually counselling women. The leaflet, which has been translated into seven different languages, was distributed to all women’s health staff and is available on the intranet and is routinely put in the antenatal information pack provided by CM Health. Because it is estimated 30% of women that birth at CM Health facility are seen by a senior medical officer a compulsory contraception field was added to their clinic letter template. Improved access to different contraception methods including: o Condoms being made available for distribution on discharge from the ward; o Further education on prescribing the contraceptive

Contraception discussion

pill and charting and administration of depo-provera; o Jadelle insertions prior to discharge; o Intra-uterine Contraceptive Device Clinic established to offer outpatient service six weeks postnatally; o An improved antenatal referral process to ensure less delays; o Developing a puerperal tubal ligation process which particularly serves the grand-multiparous population; o A pilot scheme for vasectomy (a more effective, safer and simpler procedure than tubal ligation) was very successful and has been extended and included into the sterilisation referral pathway. • Free contraceptive training for school based nurses working in secondary schools. • Reviewing the termination service: o Survey of women attending Family Planning for termination was undertaken to

2014 2015 maternity quality and safety programme  

This Annual Report (2014-2015) covers the continued progress and initiatives undertaken over the last 12 months as part of the Maternity Qua...

2014 2015 maternity quality and safety programme  

This Annual Report (2014-2015) covers the continued progress and initiatives undertaken over the last 12 months as part of the Maternity Qua...