Abstract
BackgroundDaily activities within a health care organisation are mediated by information communication processes (ICP) involving multiple health care professionals at different levels of care. Effective perinatal management requires critical information to be accurately communicated. If there is a breakdown in this communication patient safety is at risk for various reasons such as: inadequate critical information, misconception of information and uninformed decisions being made. The purpose of this study was to interpret the complexities around ICP in order to contribute to the effective management of the intrapartum period.MethodsMulti method, multiple case study approach was used to understand the ICP during the management of the intrapartum period. During the study, the expected ICP, the actual ICP, the challenges involved and the desired ICP were analysed. Twenty-four in-depth interviews with skilled birth attendants (SBAs) employing observer-as-participant roles, field notes, and document review methods were utilised to gather the data. Thematic analysis was utilised to analyse the data using Atlas TI software.ResultsThe study revealed three subthemes which emerged from the expected ICP, whilst three others that emerged formed the theme actual ICP. The subthemes from the expected ICP included: accessibility of obstetric services, expected referral, recommended tools, expected communication and expected documentation. The theme actual ICP held three emerging subthemes: the handover processes, collaborative information seeking, information communicated and referral processes.ConclusionThis study showed that what was expected was not what was actually happening. The requirements of the policies and protocols need to be effectively implemented to improve practice building these into current biomedical guidelines.
Highlights
Activities within a health care organisation are mediated by information communication processes (ICP) involving multiple health care professionals at different levels of care
Maternal mortality is referred to as death caused by complications from pregnancy or childbirth
According to the current report by the WHO, there is a decline in the Maternal Mortality Rate (MMR) from 1990 to 2013 by 45% – from 380 deaths to 210 deaths per 100 000 live births
Summary
Activities within a health care organisation are mediated by information communication processes (ICP) involving multiple health care professionals at different levels of care. Effective perinatal management requires critical information to be accurately communicated. The decline does not necessarily meet the 5.5% rate required for the three quarters reduction targeted in the MDG goal 5 by 2015.1 all regions have shown significant advancement, the levels of maternal mortality in subSaharan Africa remain unacceptably high.[1] In South Africa, the average MMR of 140 with a lower rate of 85 and 210 on the higher side indicates the need to implement further measures to reduce the lifetime risk of maternal death. Effective information communication during the management of labour and birth is an effective strategy to reduce maternal morbidity and mortality through identification of risks and abnormalities and promptly attending to them.[2] The industrialized countries have a lifetime risk of maternal death of 1 in 4000, versus 1 in 51 in countries classified as ‘least developed’.1 Effective information communication during the management of labour and birth is an effective strategy to reduce maternal morbidity and mortality through identification of risks and abnormalities and promptly attending to them.[2]
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