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Midwifery obstetric high dependency care training – a disaster waiting to happen?
  1. R Cockerill,
  2. K O'Brien,
  3. P Kochhar,
  4. L Convery,
  5. M K Whitworth
  1. St Mary's Hospital, Manchester, UK

Abstract

Background The critically ill obstetric patient poses unique challenges to the healthcare profession. The last confidential enquiry recommended that there should be a properly equipped, staffed and supervised high dependency (HD) area in every consultant-led obstetric unit. However, the DoH does not record obstetric HD beds in the 6 monthly census of UK critical care bed provision and very little is known about the skill set of midwifery staff caring for obstetric HD patients.

Methods Midwives working on the delivery unit of a busy tertiary centre were asked to complete an anonymised questionnaire about their experience and training in obstetric HD care.

Results We had 60 responses (86%). 72% of responders were direct entry midwives. 54% had received in-house training in advanced life support and 8% had attended an acute illness management course. Only 8% had received formal HD care training. 64% agreed or strongly agreed with the statement ‘I have felt out my depth looking after HD patients because of lack of knowledge’. 17% agreed or strongly agreed with the statement ‘I have received adequate training in HDU care’. Areas in which more training was felt to be required included arterial line monitoring (81%), blood gas analysis (50%) and assessing renal function (60%).

Conclusions Midwifery training programmes do not provide adequate HD care training. In house training sessions in the practical aspects of providing HD care have been arranged and a formal programme of study is being developed. We are looking to engage with the local undergraduate programme directors.

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