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Routine postnatal care of women and their babies

Routine postnatal care of women and their babies. July, 2006. 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

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Routine postnatal care of women and their babies

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  1. Routine postnatal care of women and their babies July, 2006

  2. 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

  3. 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

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

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

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

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

  8. Planning content and delivery of care • Documented, individualised care plan • Written communication • Relevant and timely information

  9. 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 Suggested actions

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

  11. 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 Suggested actions

  12. 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 Infant feeding

  13. 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 Suggested actions

  14. 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

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

  16. 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

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

  18. 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

  19. 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

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

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

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