Abstract
In this chapter a process of changing clinical practice is presented with help of change management theory. The chapter is based on experiences from Norwegian hospitals in implementing a change in clinical practice during second stage of labour to reduce the incidence of obstetric anal sphincter injuries (OASIS). Training and educating Norwegian midwives and doctors on the labour wards to protect perineum during second stage of labour achieved the reduced incidence of OASIS. The educational programme included the entire staff involved in intra-partum care, both doctors and midwives, regardless of their length of experience in maternity practice. It is well recognised that educational programmes aiming to change an existing practice to a new method is a challenging process, hence, enthusiasm, leadership and resources are paramount.
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References
Selecting Indicators for Patient Safety at the Health Systems Level in OECD Countries. 2004. http://www.oecd.org/dataoecd. p. 31–2.
Laine K, Pirhonen T, Rolland R, Pirhonen J. Decreasing the incidence of anal sphincter tears during delivery. Obstet Gynecol. 2008;111(5):1053–7.
Hals E, Øian P, Pirhonen T, Gissler M, Hjelle S, Nilsen EB, et al. A multicenter interventional program to reduce the incidence of anal sphincter tears. Obstet Gynecol 2010 Oct;116(4):901–8.
Laine K, Skjeldestad FE, Sandvik L, Staff AC. Incidence of obstetric anal sphincter injuries after training to protect the perineum: cohort study. BMJ Open. 2012;2:5. 10.1136/bmjopen-2012-001649. Print 2012.
Stedenfeldt M, Oian P, Gissler M, Blix E, Pirhonen J. Risk factors for obstetric anal sphincter injury after a successful multicentre interventional programme. BJOG. 2014;121(1):83–91.
Laine K, Rotvold W, Staff AC. Are obstetric anal sphincter ruptures preventable?- Large and consistent rupture rate variations between the Nordic countries and between delivery units in Norway. Acta Obstet Gynecol Scand. 2012;92(1):94–100.
Medisinsk fødselsregister M. The medical birth registry, Norwegian Institute of Public Health. n.d. Available at: www.mfr.no.
Leenskjold S, Hoj L, Pirhonen J. Manual protection of the perineum reduces the risk of obstetric anal sphincter ruptures. Dan Med J. 2015;62(5):A5075.
Basu M, Smith D, Edwards R, STOMP Project Team. Can the incidence of obstetric anal sphincter injury be reduced? The STOMP experience. Eur J Obstet Gynecol Reprod Biol. 2016;202:55–9.
Hals E, Øian P, Pirhonen T, Gissler M, Hjelle S, Nilsen EB, et al. A multicenter interventional program to reduce the incidence of anal sphincter tears. Obstet Gynecol. 2010;116(4):901–8.
Pirhonen T, Gissler M, Hartgill T, Pirhonen J. Experiences of expert midwives in a training program aimed at decreasing perineal tears. Int J Nurs MIdwifery. 2011;3(6):70–5.
Hewitt-Taylor J. Understanding & managing change in healthcare. A step-by-step guide. 1st ed. Palgrave Macmillan: Hampshier; 2013.
Pirhonen JP, Grenman SE, Haadem K, Gudmundsson S, Lindqvist P, Siihola S, et al. Frequency of anal sphincter rupture at delivery in Sweden and Finland – result of difference in manual help to the baby’s head. Acta Obstet Gynecol Scand. 1998;77(10):974–7.
Räisänen S, Vehviläinen-Julkunen K, Gissler M, Heinonen S. High episiotomy rate protects from obstetric anal sphincter ruptures: a birth register-study on delivery intervention policies in Finland. Scand J Public Health. 2011;39(5):457–63.
Räisänen S, Vehviläinen-Julkunen K, Gissler M, Heinonen S. Up to seven-fold inter-hospital differences in obstetric anal sphincter injury rates – a birth register-based study in Finland. BMC Res Notes. 2010;3(1):345.
Gurol-Urganci I, Cromwell DA, Edozien LC, Mahmood TA, Adams EJ, Richmond DH, et al. Third- and fourth-degree perineal tears among primiparous women in England between 2000 and 2012: time trends and risk factors. BJOG. 2013;120(12):1516–25.
Bulchandani S, Watts E, Sucharitha A, Yates D, Ismail KM. Manual perineal support at the time of childbirth: a systematic review and meta-analysis. BJOG. 2015;122(9):1157–65.
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Laine, K., Räisänen, S. (2016). Role of Training to Reduce Perineal Trauma at an Organsiational Level. In: Ismail, K. (eds) Perineal Trauma at Childbirth. Springer, Cham. https://doi.org/10.1007/978-3-319-14860-1_11
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DOI: https://doi.org/10.1007/978-3-319-14860-1_11
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