Bristol Medical School, Department of Translational Health Sciences, University of Bristol, Faculty of Health Sciences, Bristol, UK
Bristol Medical School, Department of Translational Health Sciences, University of Bristol, Faculty of Health Sciences, Bristol, UK.
BMJ Open. 2021 Mar 16;11(3):e044563. doi: 10.1136/bmjopen-2020-044563.
When a formal review of care takes places after the death of a baby, parents are largely unaware it takes place and are often not meaningfully involved in the review process. Parent engagement in the process is likely to be essential for a successful review and to improve patient safety. This study aimed to evaluate an intervention process of parental engagement in perinatal mortality review (PNMR) and to identify barriers and facilitators to its implementation.
Mixed-methods study of parents' engagement in PNMR.
Single tertiary maternity unit in the UK.
Bereaved parents and healthcare professionals (HCPs).
Parent engagement in the PNMR (intervention) was based on principles derived through national consensus and qualitative research with parents, HCPs and stakeholders in the UK.
Recruitment rates, bereaved parents and HCPs' perceptions.
Eighty-one per cent of bereaved parents approached (13/16) agreed to participate in the study. Two focus groups with bereaved parents (n=11) and HCP (n=7) were carried out postimplementation to investigate their perceptions of the process.Overarching findings were improved dialogue and continuity of care with parents, and improvements in the PNMR process and patient safety. Bereaved parents agreed that engagement in the PNMR process was invaluable and helped them in their grieving. HCP perceived that parent involvement improved the review process and lessons learnt from the deaths; information to understand the impact of aspects of care on the baby's death were often only found in the parents' recollections.
Parental engagement in the PNMR process is achievable and useful for parents and HCP alike, and critically can improve patient safety and future care for mothers and babies. To learn and prevent perinatal deaths effectively, all hospitals should give parents the option to engage with the review of their baby's death.
当婴儿死亡后进行正式的护理审查时,父母通常对此并不知情,也很少能真正参与审查过程。父母参与审查过程对于审查的成功和提高患者安全性可能至关重要。本研究旨在评估一种父母参与围产儿死亡审查(PNMR)的干预流程,并确定实施过程中的障碍和促进因素。
对父母参与 PNMR 的情况进行混合方法研究。
英国一家单一的三级妇产医院。
失去孩子的父母和医疗保健专业人员(HCP)。
父母参与 PNMR(干预)基于通过国家共识和与英国的父母、HCP 和利益相关者进行的定性研究得出的原则。
招募率、失去孩子的父母和 HCP 的看法。
81%(13/16)接触的失去孩子的父母同意参与研究。实施后进行了两次焦点小组讨论,一次是与失去孩子的父母(n=11),一次是与 HCP(n=7),以调查他们对该过程的看法。总体发现是与父母的对话得到改善,护理的连续性得到改善,PNMR 过程和患者安全性得到提高。失去孩子的父母一致认为,参与 PNMR 过程非常宝贵,并帮助他们缓解悲痛。HCP 认为父母的参与改善了审查过程,从死亡中吸取了教训;了解护理方面对婴儿死亡的影响的信息通常只能从父母的回忆中找到。
父母参与 PNMR 过程对父母和 HCP 都是可行且有用的,并且可以显著提高患者安全性和母婴未来的护理质量。为了有效地学习和预防围产期死亡,所有医院都应该给父母选择参与审查他们孩子死亡的机会。