O'Connor Emily, Helps Aenne, Greene Richard, O'Donoghue Keelin, Leitao Sara
INFANT Research Centre, 8795 University College Cork , Cork, Ireland.
Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, 8795 University College Cork , Cork, Ireland.
J Perinat Med. 2025 Mar 19;53(4):454-466. doi: 10.1515/jpm-2024-0601. Print 2025 May 26.
Perinatal death reviews investigate the causes of perinatal mortality, identify potentially avoidable factors, and may help prevent further deaths. This study aimed to identify barriers and facilitators to the implementation of a standardised perinatal mortality review tool in Irish maternity units by engaging with healthcare professionals about their opinions on the existing system and implementing a standardised system.
This study involved semi-structured interviews with staff from three maternity units of various sizes in Ireland. Recruitment involved purposive and snowball sampling. Interviews took place from May to December 2022 and covered topics such as the existing perinatal mortality review process, staff experiences with reviews and proposed changes to the system. Thematic analysis was performed.
Participants (n=32) included medical and midwifery staff with varying levels of seniority and experience with perinatal mortality reviews. Four themes were identified: the review process, time challenges of reviews, institutional culture and staff needs. Our findings demonstrated that the review process was structured differently across units, with varying levels of staff involvement. Institution culture, leadership and transparency were highlighted as essential aspects of the review process. Reviews have an impact on staff wellbeing, emphasising the need for continued support.
Implementing a standardised perinatal mortality review system is viewed positively by staff, though addressing the highlighted barriers to change is important. A standardised perinatal mortality review tool and review process may help strengthen perinatal death reviews, provide more information and opportunity for involvement for bereaved parents and help reduce future perinatal deaths.
围产期死亡审查旨在调查围产期死亡率的原因，识别潜在可避免的因素，并可能有助于预防进一步的死亡。本研究旨在通过与医疗保健专业人员就他们对现有系统的看法进行交流并实施标准化系统，来识别爱尔兰 maternity 单位实施标准化围产期死亡审查工具的障碍和促进因素。
本研究对爱尔兰三个不同规模 maternity 单位的工作人员进行了半结构化访谈。招募采用了目的抽样和滚雪球抽样。访谈于2022年5月至12月进行，涵盖了现有围产期死亡审查过程、工作人员的审查经历以及对系统的拟议更改等主题。进行了主题分析。
参与者（n = 32）包括具有不同资历和围产期死亡审查经验的医疗和助产人员。确定了四个主题：审查过程、审查的时间挑战、机构文化和工作人员需求。我们的研究结果表明，各单位的审查过程结构不同，工作人员的参与程度也不同。机构文化、领导力和透明度被强调为审查过程的重要方面。审查对工作人员的幸福感有影响，强调了持续支持的必要性。
工作人员对实施标准化围产期死亡审查系统持积极看法，尽管解决突出的变革障碍很重要。标准化的围产期死亡审查工具和审查过程可能有助于加强围产期死亡审查，为失去亲人的父母提供更多信息和参与机会，并有助于减少未来的围产期死亡。
