from the Intrapartum Fetal Heart Rate Monitoring Audit 2006 Robyn Maude Midwife Leader, WHS

1. Practice InnovationTool for the interpretation, classification, action planning and documentation of Electronic Fetal Monitoring (EFM) from the Intrapartum Fetal Heart Rate Monitoring Audit 2006 Robyn Maude Midwife Leader, WHS

2. The Problem • Case reviews following adverse obstetric outcome have identified concerns in relation to fetal monitoring practice, especially interpretation and documentation of the findings of cardiotocographs (CTG’s)

3. The Audit • Audit Question: How well does the practice of midwifery and medical staff comply with the C&CDHB policy on Intrapartum Electronic Fetal Monitoring (EFM) and Fetal Blood Sampling (FBS) (WHS Intrapartum D-10), including Structured Intermittent Auscultation? • Audit Aims • Determine compliance with policy • Examine the interpretation and classification of CTG’s in relation to the policy • Assess that documentation

4. The Findings • This audit demonstrates that practitioners at WHS are not using the guidelines adequately or effectively. The consequence of this policy not being used correctly is an increased risk to women and their babies, the service and DHB

5. The Solution – Sticky Label

6. The Outcome • Use of a standardised language for the interpretation of the findings of fetal heart rate monitoring, as outlined in the policy, will improve interpretation of CTG’s and assist timely action. • Introduction of a sticky label for CTG assessment, interpretation and action planning will contribute to improved practice, better outcomes and reduced risk.

7. Links • CTG Label Poster - A1 (4).pdf • ..\PhD\Audit\Final Report Intrapartum Fetal Monitoring Audit.doc