Intelligent Structured Intermittent Auscultation (ISIA): Evaluation of a decision-making framework for fetal heart monitoring of low-risk women

Maude, RM; Skinner, JP; Foureur, MJ

Intelligent Structured Intermittent Auscultation (ISIA): Evaluation of a decision-making framework for fetal heart monitoring of low-risk women

Maude, RM Skinner, JP Foureur, MJ

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Publication Type:: Journal Article
Citation:: BMC Pregnancy and Childbirth, 2014, 14 (1)
Issue Date:: 2014-05-31

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Field	Value	Language
dc.contributor.author	Maude, RM	en_US
dc.contributor.author	Skinner, JP	en_US
dc.contributor.author	Foureur, MJ https://orcid.org/0000-0002-0454-0165	en_US
dc.date.available	2014-05-27	en_US
dc.date.issued	2014-05-31	en_US
dc.identifier.citation	BMC Pregnancy and Childbirth, 2014, 14 (1)	en_US
dc.identifier.uri	http://hdl.handle.net/10453/33073
dc.identifier.uri	http://hdl.handle.net/10453/33112
dc.description.abstract	Background: Research-informed fetal monitoring guidelines recommend intermittent auscultation (IA) for fetal heart monitoring for low-risk women. However, the use of cardiotocography (CTG) continues to dominate many institutional maternity settings.Methods: A mixed methods intervention study with before and after measurement was undertaken in one secondary level health service to facilitate the implementation of an initiative to encourage the use of IA. The intervention initiative was a decision-making framework called Intelligent Structured Intermittent Auscultation (ISIA) introduced through an education session.Results: Following the intervention, medical records review revealed an increase in the use of IA during labour represented by a relative change of 12%, with improved documentation of clinical findings from assessments, and a significant reduction in the risk of receiving an admission CTG (RR 0.75, 95% CI, 0.60 - 0.95, p = 0.016).Conclusion: The ISIA informed decision-making framework transformed the practice of IA and provided a mechanism for knowledge translation that enabled midwives to implement evidence-based fetal heart monitoring for low risk women. © 2014 Maude et al.; licensee BioMed Central Ltd.	en_US
dc.relation.ispartof	BMC Pregnancy and Childbirth	en_US
dc.relation.isbasedon	10.1186/1471-2393-14-184	en_US
dc.subject.classification	Obstetrics & Reproductive Medicine	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Cardiotocography	en_US
dc.subject.mesh	Heart Auscultation	en_US
dc.subject.mesh	Fetal Monitoring	en_US
dc.subject.mesh	Patient Admission	en_US
dc.subject.mesh	Risk Factors	en_US
dc.subject.mesh	Program Evaluation	en_US
dc.subject.mesh	Attitude of Health Personnel	en_US
dc.subject.mesh	Decision Making	en_US
dc.subject.mesh	Evidence-Based Medicine	en_US
dc.subject.mesh	Midwifery	en_US
dc.subject.mesh	Pregnancy	en_US
dc.subject.mesh	Labor, Obstetric	en_US
dc.subject.mesh	Heart Rate, Fetal	en_US
dc.subject.mesh	Decision Support Techniques	en_US
dc.subject.mesh	Unnecessary Procedures	en_US
dc.subject.mesh	Guideline Adherence	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Practice Guidelines as Topic	en_US
dc.title	Intelligent Structured Intermittent Auscultation (ISIA): Evaluation of a decision-making framework for fetal heart monitoring of low-risk women	en_US
dc.type	Journal Article
utslib.citation.volume	1	en_US
utslib.citation.volume	14	en_US
utslib.for	1110 Nursing	en_US
utslib.for	1114 Paediatrics and Reproductive Medicine	en_US
utslib.for	1117 Public Health and Health Services	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Midwifery
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	open_access
pubs.issue	1	en_US
pubs.publication-status	Published	en_US
pubs.volume	14	en_US

Abstract:

Background: Research-informed fetal monitoring guidelines recommend intermittent auscultation (IA) for fetal heart monitoring for low-risk women. However, the use of cardiotocography (CTG) continues to dominate many institutional maternity settings.Methods: A mixed methods intervention study with before and after measurement was undertaken in one secondary level health service to facilitate the implementation of an initiative to encourage the use of IA. The intervention initiative was a decision-making framework called Intelligent Structured Intermittent Auscultation (ISIA) introduced through an education session.Results: Following the intervention, medical records review revealed an increase in the use of IA during labour represented by a relative change of 12%, with improved documentation of clinical findings from assessments, and a significant reduction in the risk of receiving an admission CTG (RR 0.75, 95% CI, 0.60 - 0.95, p = 0.016).Conclusion: The ISIA informed decision-making framework transformed the practice of IA and provided a mechanism for knowledge translation that enabled midwives to implement evidence-based fetal heart monitoring for low risk women. © 2014 Maude et al.; licensee BioMed Central Ltd.

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http://hdl.handle.net/10453/33073