Regional learning to improve health outcomes for pre-term babies
North Devon District Hospital hosted an education day for clinical staff to share learning from the Prenatal Excellence to reduce Injury in Premature Births (PERIPrem) programme around care for pre-term babies.
During the event, staff had the opportunity to learn about the impact the programme has had so far in the region and how multi-disciplinary working helps to improve pre-term outcomes for babies. They were also able to watch a live simulation of an emergency caesarean section and optimal cord clamping, which applied the principles from the 11-element perinatal care bundle of the programme.
In this blog, Charlotte Bisset, Senior Neonatal Staff Nurse and Clinical Educator at North Devon District Hospital, reflects on her experience of the day and the learning she intends to implement within her own practice and team.
“The PERIPrem Education Day was run by Swindon Neonatal Consultant and PERIPrem Clinical Operation Lead for the programme, Dr Sarah Bates and colleagues, with support from Health Innovation South West. The aim was to provide an in-depth understanding of the programme to staff who were new to the programme and an update for those already involved, to enhance the knowledge of the multi-disciplinary team delivering the care bundle.
“As a new member of the PERIPrem team, it was great to meet the multi-disciplinary team (MDT) in attendance, which was made up of members from obstetric and neonatal units across the South West Neonatal Network. Everyone was so welcoming and supportive.
“There were also multiple theatre team members attending, which helped me better understand their role in PERIPrem, as it is not very often we get time together in a non-clinical situation to problem-solve and understand each other’s challenges.
“The day started with a very informative presentation from Dr Sarah Bates, who inspired the room with her passion for PERIPrem as well as clearly explaining why each element is so important and how we as a Trust are currently performing, using local data collected each month and both regional and national figures. The Q&A session that followed engaged members of the MDT to help them recognise how they could be involved and clarified any queries they had.
“Whilst working alongside the PERIPrem programme as a senior neonatal nurse, I understood what the 11 PERIPrem bundle elements were, but not quite the full impact these simple elements could make to a preterm infant’s future health. However, Dr Bates clearly explained how the elements were being implemented and the importance of these. She emphasised how vital it is that we as professionals put in steps to ensure that infants receive optimal cord management (OCM) and stay within the optimal temperature parameters for a positive neonatal outcome.
“The second half of the day involved a simulation of a preterm delivery, which was especially useful from a practical perspective as it showed the layout of theatre and how optimal cord management can be achieved, along with knowledge-sharing from other units. Supporting OCM in an infant requiring additional care has been an area I have lacked confidence in previously, but watching the simulation has allowed me to feel confident in moving the equipment to the correct position to deliver supportive measures to the infant whilst achieving OCM. As the Neonatal Clinical Educator, I plan to introduce this as a part of the Tier 2 doctors’ orientation training, so that before starting with the Trust they are aware of how we deliver PERIPrem in North Devon, where equipment is stored, and how they can access other PERIPrem resources.
I also intend to deliver some training to the neonatal nurses who attend deliveries so that they feel more comfortable in implementing the elements of the PERIPrem bundle and supporting members of the neonatal medical team to do so too.
“The event has inspired me to become more involved in PERIPrem and embed the PERIPrem elements in other training delivered to both the medical and nursing team working with neonates. I am keen to be more involved with the PERIPrem project in the future and as part of this network with the wider MDT. It was lovely to see so many individuals inspired to take ownership of this improvement project as a result of their attendance.
“We also plan to film a simulation for staff involved in the delivery of a preterm infant to share knowledge and increase confidence so that it is accessible for all. This will help ensure that we sustain the the improvements we have already made as a Trust, which include the probiotics, early breast milk and magnesium sulphate elements, but also look at new ways of working so we continue to make improvements to provide the best outcomes for infants born preterm in North Devon.”
About the PERIPrem programme
Preterm birth is the single biggest cause of infant mortality and newborn brain injury in England. The NHS Long Term Plan has committed to realising a 50% reduction in stillbirth, maternal and neonatal mortality, and serious brain injury by 2025, with an increased focus on preterm mortality.
PERIPrem is a unique care bundle of 11 evidence-based interventions for mothers and preterm babies which has been implemented in 12 Trusts across the South West region. The programme is led by Health Innovation West of England in partnership with Health Innovation South West and the South West Neonatal Network.
As part of our role in supporting the programme, we were commissioned to evaluate PERIPrem to understand the effectiveness of using QI methodology to support maternity and neonatal units in implementing a standardised bundle of care to mothers who deliver their babies at less than 34 weeks’ gestation. The evaluation was published in BMJ Open Quality and shows that the PERIPrem bundle and QI approach has increased uptake of these 11 interventions in 12 Trusts across the South West as well as improved perinatal culture.
Read more about the programme here. If you have any questions, please contact, Sally Hedge, Programme Manager, Health Innovation South West.
