Masters Degrees (Nursing and Midwifery)

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Browsing Masters Degrees (Nursing and Midwifery) by Author "Anthony, Victoria Jenine"

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    Informational continuity approaches during birth within primary health care settings in the Western Cape : experiences of midwives
    (Stellenbosch : Stellenbosch University, 2023-03) Anthony, Victoria Jenine; Kaura, Doreen K; Robertson, Anneline; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    ENGLISH SUMMARY: Background: The World Health Organization (WHO) framework on integrated people-centered health services focus on continuity and coordination of care in primary health care settings. This framework includes informational continuity as an approach to reach universal health coverage. According to the WHO, continuity of care includes four approaches, namely informational, interpersonal, longitudinal and management continuity. Informational continuity during birth is a critical factor in the prevention of maternal morbidity and mortality and the reduction of duplication of services and fragmentation of care. The aim of this study was to explore the experiences of midwives regarding informational continuity approaches used while providing maternity care for pregnant women in maternity obstetric units (MOUs) in the Tygerberg subdistrict of the Cape Town Metropole in the Western Cape, South Africa. Methods: A qualitative descriptive phenomenological study approach was used to explore the lived experiences of midwives in MOUs regarding informational continuity approaches during birth. Purposive sampling was used to select participants from two MOUs in the Western Cape. Prior to data collection, approval was obtained from the Health Research Ethics Committee of Stellenbosch University and the Department of Health of the Western Cape. Eleven semi- structured online interviews were conducted, transcribed, and analyzed using Giorgi’s phenomenological analytical approach. Findings: The following themes emerged: Theme one: The communication of midwives with pregnant women. Theme two: The communication between midwives and other health care providers. Theme three: Documentation during birth. Theme four: The use of standardised clinical guidelines. The findings revealed that midwives effectuated positive patient-provider relationships by providing women with prompt communication and building good relationships. The continuous communication among midwives and with other health care providers ensured collective memory among the health care providers since all the health care providers had the same information regarding the women in their care. The midwives made use of synchronised care records that included the maternity case record (MCR), the partogram and the identify, situation, background, assessment and recommendation (ISBAR) tool to communicate effectively. Standardised clinical guidelines were used to facilitate standardised maternity care. The challenges identified were challenges in communication with the women due to language barriers and women not bringing their MCR with to the MOUs. Communication challenges among midwives and with other health care providers identified were incomplete documentation, inaccessible records and incomplete handover of information during handover rounds and referrals. Recommendations included, to allow women to bring their own interpreter to the MOUs, regular in-service training for staff on communication and recordkeeping skills and regular training for midwives on clinical guidelines. Conclusion: The findings demonstrated that overcoming the challenges in communication in the MOUs would ensure that informational continuity is accomplished through effective communication among the midwives and with other health care providers and the pregnant women in the MOUs. Hence, informational continuity during birth is an integral component of providing quality maternity care in MOUs.