Birtrate Plus ® – Ward Acuity Tool
Cath Murray, Project Midwife and Lead Adviser on Ward Acuity Project gives an update on the development and pilot studies for this exiting project.
Safe Staffing on antenatal and postnatal wards
The NICE guidelines on Safe Staffing emphasise the need to ensure adequate resources to meet the needs of woman but assessing that need is a complex task
Midwives and support staff know how fast paced the workload can be. Admissions 24/7 from labour ward and triage and daily from antenatal clinics, quick turnaround of patients with many discharged in the first 24 hours. Add to this the increase in the number of baby observations, high risk post natal and antenatal women, paperwork, answering problems on the phone and it becomes obvious that staff are working flat out to keep providing high quality and increasingly intensive care.
Post-natal care is often referred to as the ‘Cinderella service’ and staff are no strangers to multi-tasking; It’s not uncommon to do a post-natal check, answer the door bell on the way to get medication from the drug cupboard, pop your head round the door to answer a bell and let a patient know you’ll be in shortly to assist with breast feeding, advise a patient you’ll have her documentation completed for discharge in the next hour etc. and take a bite of a sandwich and a quick drink on the way past the nursing station and that’s just 15 minutes of the 12 hour shift! We can all relate to the scenario, but although we have the standard of one to one care for labour, there is no documentated standard to measure how much care we should give our antenatal and postnatal inpatients to meet their differing physical and emotional needs and how many staff do we need to do this effectively.
How to assess fluctuating need……developing the Tool
In response to demand from many units, Birthrate Plus® have developed a ward acuity tool to proactively assess the clinical needs of the women on the ward and match them against the staff available. The tool is an excel spreadsheet; data is inputted at the beginning of a shift for the expected activity. The data collection covers all women in the ward, classified according to their clinical and social needs. Antenatal women are classified by clinical indicators. Further data is collected to record women or babies who may have extra needs. For each category an agreed amount of staff time is allocated. Thus the excel sheet calculates the staff hours needed based upon the client need and compares them with the staff hours available on that shift.
Development of the ward acuity tool was undertaken with excellent contribution from 3 maternity units in North Wales and further testing in some units in England, including 6 hospitals in the North West.
Birthrate Plus is seeing a growing demand for both the Intrapartum and Ward based tools, as Trusts see the value of capturing real time evidence of clinical activity, presented with helpful graphs and analysis.