CG37presenterslides

Slide1 : Routine postnatal care of women and their babies July, 2006


Changing clinical practice : Changing clinical practice NICE guidelines are based on the best available evidence The Department of Health asks NHS organisations to work towards implementing guidelines Compliance will be monitored by the Healthcare Commission Changes should be linked with other NICE guidance and relevant national policies


The postnatal period : The postnatal period The guideline covers maternal and infant care in the period after transfer from intrapartum care until the end of the postnatal period. This is usually 6–8 weeks after the birth


Need for the guideline : Need for the guideline Common health problems in the postnatal period Dissatisfaction of those receiving care Creating services which are woman and family centred


Aim of the guideline : Aim of the guideline Appropriate objectives, purpose, content and timing Best practices and competencies for assessment Information, education and support Planning Good practice in communication


Essential principles of care : Essential principles of care Kindness, respect and dignity Views, beliefs and values Women’s full involvement All actions and interventions fully explained Supporting informed decisions


This guideline covers : This guideline covers Planning the content and delivery of care for woman and baby Maintaining maternal health Infant feeding Maintaining infant health


Planning content and delivery of care : Planning content and delivery of care Documented, individualised care plan Written communication Relevant and timely information


Suggested actions : Suggested actions Local care planning documentation and use Local protocols about written communication Quality of local information provision for effectiveness and relevance to local community Identifying the named postnatal coordinator within the care plan


Maintaining maternal health : Maintaining maternal health Signs and symptoms of potentially life-threatening conditions: postpartum haemorrhage infection pre-eclampsia/eclampsia Thromboembolism Emotional wellbeing


Suggested actions : Suggested actions Local protocols within primary and secondary care Continuous professional development programmes Maternity and Care of the Newborn Competence Frameworks Clinical Negligence Scheme for Trusts (CNST) standards


Infant feeding : Infant feeding Programme to encourage breastfeeding, using an externally evaluated structured programme using the Baby Friendly Initiative as a minimum standard Support of breastfeeding initiation and continuation


Suggested actions : Suggested actions Look at the UNICEF UK Baby Friendly Initiative which provides one possible framework for implementing an externally evaluated, structured programme which supports breastfeeding. This can be used by NHS trusts, other healthcare facilities and higher education institutions www.babyfriendly.org.uk


Maintaining infant health : Maintaining infant health Information and guidance offered to enable parents to: assess their baby’s general condition identify signs and symptoms of common health problems seen in babies contact a healthcare professional or emergency service if required


Suggested actions : Suggested actions Distribution of ‘Birth to five’ Quality of local information Named postnatal coordinator within the care plan Maternity and Care of the Newborn Competence Frameworks


Costs and savings : Costs and savings Use NICE costing tools to identify recommendations with the greatest impact on resources savings savings are linked to the reduction in the incidence of certain childhood disease because of the protective effects of breastfeeding costs structured programme that encourages breastfeeding including training


Access tools online : Access tools online Costing tools costing report costing template Implementation advice Audit criteria Available from: www.nice.org.uk/cg037


Access the guideline online : Access the guideline online quick reference guide – a summary www.nice.org.uk/CG037quickrefguide NICE guideline – all of the recommendations www.nice.org.uk/CG037niceguideline full guideline – all of the evidence and rationale www.nice.org.uk/CG037fullguideline ‘Understanding NICE guidance’ – a plain English version www.nice.org.uk/CG037publicinfo


Care pathway : Care pathway Key components – maintaining maternal health, infant feeding, and maintaining infant health Time bands – first 24 hours, first week and first 2–8 weeks after birth Action levels – emergency, urgent and non-urgent Includes – core information, core care and areas for concern


Example: signs of thromboembolism : Example: signs of thromboembolism Area for concern: unilateral calf pain and redness or swelling Emergency action Time band 24 hours Maintaining maternal health


Example: routine immunisations : Example: routine immunisations Core care Time band 2–6 weeks Offer routine baby immunisations