Saving Babies' Lives Project Impact and Results Evaluation: a Mixed Methodology Study
NCT ID: NCT03231007
Last Updated: 2018-12-04
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
4952 participants
OBSERVATIONAL
2017-07-10
2018-07-05
Brief Summary
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To determine the impact of the care bundle on pregnancy outcomes, birth data and other clinical measures will be extracted from maternity databases and case-note audit from before and after implementation. Additionally, this study will employ questionnaires with organisational leads and review clinical guidelines to assess how resources, leadership and governance may affect implementation in diverse hospital settings. The cost of implementing the care bundle, and the cost per stillbirth avoided, will also be estimated as part of a health economic analysis. The views and experiences of service users and service providers towards maternity care in relation to the care bundle will be also be sought using questionnaires.
This study will provide practice-based evidence to advance knowledge about the processes that underpin successful implementation of the care bundle so that it can be further developed and refined. This has the potential to translate into substantial improvements in the rate of late stillbirth in the UK should the care bundle be proved effective.
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Detailed Description
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Conditions
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Study Design
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OTHER
CROSS_SECTIONAL
Study Groups
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Innovators
Maternity units that implemented the Care Bundle to the highest level (according to an NHS survey in 2015) are categorised as 'Innovators'.
Questionnaire
A structured questionnaire will be administered to maternity service users. Another structured questionnaire will be administered to maternity healthcare professionals, and another to Organisational Leads (e.g. Clinical Directors at each site).
Early Adopters
Maternity units that implemented the Care Bundle to the second-highest level (according to an NHS survey in 2015) are categorised as 'Early Adopters'.
Questionnaire
A structured questionnaire will be administered to maternity service users. Another structured questionnaire will be administered to maternity healthcare professionals, and another to Organisational Leads (e.g. Clinical Directors at each site).
Late Adopters
Maternity units that implemented the Care Bundle to the third-highest level (according to an NHS survey in 2015) are categorised as 'Late Adopters'.
Questionnaire
A structured questionnaire will be administered to maternity service users. Another structured questionnaire will be administered to maternity healthcare professionals, and another to Organisational Leads (e.g. Clinical Directors at each site).
Low Adopters
Maternity units that implemented the Care Bundle to the fourth-highest level (according to an NHS survey in 2015) are categorised as 'Low Adopters'.
Questionnaire
A structured questionnaire will be administered to maternity service users. Another structured questionnaire will be administered to maternity healthcare professionals, and another to Organisational Leads (e.g. Clinical Directors at each site).
Interventions
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Questionnaire
A structured questionnaire will be administered to maternity service users. Another structured questionnaire will be administered to maternity healthcare professionals, and another to Organisational Leads (e.g. Clinical Directors at each site).
Eligibility Criteria
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Inclusion Criteria
* Women who have given birth after 28 weeks of gestation
* Midwives working before and after implementation of the care bundle (including antenatal ward, antenatal clinic, community-based staff, antenatal assessment unit and labour ward)
* Community midwives working before and after implementation of the care bundle
* Sonographers working before and after implementation of the care bundle
* Junior doctors working before and after implementation of the care bundle
* Consultant obstetricians working before and after implementation of the care bundle
* Clinical Directors and Heads of Midwifery working before and after implementation of the care bundle
Exclusion Criteria
* Individuals who cannot understand/not fluent in English (to enable consent without interpreter)
* Multiple pregnancy
* Fetuses known to have any congenital or severe structural abnormalities
* Home births
\- Staff who were employed after the care bundle was implemented
16 Years
ALL
No
Sponsors
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Somerset NHS Foundation Trust
OTHER
Royal Devon and Exeter NHS Foundation Trust
OTHER
University Hospital Plymouth NHS Trust
OTHER
Royal United Hospital Bath NHS Trust
OTHER
North Bristol NHS Trust
OTHER
Liverpool Women's NHS Foundation Trust
OTHER
St Helens & Knowsley Teaching Hospitals NHS Trust
OTHER
Countess of Chester NHS Foundation Trust
OTHER
University Hospitals of Morecambe Bay NHS Trust
OTHER
Barnsley Hospital NHS Foundation Trust
OTHER
Doncaster And Bassetlaw Hospitals NHS Foundation Trust
OTHER
York Teaching Hospitals NHS Foundation Trust
OTHER
Hull University Teaching Hospitals NHS Trust
OTHER_GOV
Mid Yorkshire Teaching NHS Trust
OTHER
Oxford University Hospitals NHS Trust
OTHER
Gateshead Health NHS Foundation Trust
OTHER
North Cumbria University Hospitals NHS Trust
OTHER
Sherwood Forest Hospitals NHS Foundation Trust
OTHER
Manchester University NHS Foundation Trust
OTHER_GOV
Birmingham Women's NHS Foundation Trust
OTHER_GOV
University of Manchester
OTHER
Responsible Party
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Dr Alexander Heazell
Professor of Obstetrics
Locations
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Barnsley Hospital NHS Foundation Trust
Barnsley, , United Kingdom
Royal United Hospitals Bath NHS Foundation Trust
Bath, , United Kingdom
Birmingham Women's and Children's NHS Foundation Trust
Birmingham, , United Kingdom
North Bristol NHS Trust
Bristol, , United Kingdom
North Cumbria University Hospitals NHS Trust
Carlisle, , United Kingdom
Countess of Chester Hospital NHS Foundation Trust
Chester, , United Kingdom
Doncaster and Bassetlaw Hospitals NHS Foundation Trust
Doncaster, , United Kingdom
Royal Devon & Exeter NHS Foundation Trust
Exeter, , United Kingdom
Gateshead Health NHS Foundation Trust
Gateshead, , United Kingdom
Oxford University Hospitals NHS Trust
Headington, , United Kingdom
Hull and East Yorkshire Hospital NHS Trust
Hull, , United Kingdom
University Hospitals of Morecambe Bay NHS Foundation Trust
Kendal, , United Kingdom
Liverpool Women's NHS Foundation Trust
Liverpool, , United Kingdom
Central Manchester University Hospitals NHS Foundation Trust
Manchester, , United Kingdom
Plymouth Hospital NHS Trust
Plymouth, , United Kingdom
St Helens and Knowsley Teaching Hospitals NHS Trust
Prescot, , United Kingdom
Sherwood Forest Hospitals NHS Foundation Trust
Sutton in Ashfield, , United Kingdom
Taunton and Somerset NHS Foundation Trust
Taunton, , United Kingdom
The Mid Yorkshire Hospitals NHS Trust
Wakefield, , United Kingdom
York Teaching Hospital NHS Foundation Trust
York, , United Kingdom
Countries
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References
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Office of National Statistics. Characteristics of birth 1, England and Wales, 2013. London: ONS, 2014.
Flenady V, Wojcieszek AM, Middleton P, Ellwood D, Erwich JJ, Coory M, Khong TY, Silver RM, Smith GCS, Boyle FM, Lawn JE, Blencowe H, Leisher SH, Gross MM, Horey D, Farrales L, Bloomfield F, McCowan L, Brown SJ, Joseph KS, Zeitlin J, Reinebrant HE, Cacciatore J, Ravaldi C, Vannacci A, Cassidy J, Cassidy P, Farquhar C, Wallace E, Siassakos D, Heazell AEP, Storey C, Sadler L, Petersen S, Froen JF, Goldenberg RL; Lancet Ending Preventable Stillbirths study group; Lancet Stillbirths In High-Income Countries Investigator Group. Stillbirths: recall to action in high-income countries. Lancet. 2016 Feb 13;387(10019):691-702. doi: 10.1016/S0140-6736(15)01020-X. Epub 2016 Jan 19.
Manktelow BN, S.L., Seaton SE, Hyman-Taylor P, Kurinczuk JJ, Field DJ. MBRRACE-UK Perinatal Mortality Surveillance Report, UK Perinatal Deaths for Births from Janurary to December 2014. Leicester: The Infant Mortality and Morbidity Studies, Department of Health Sciences, University of Leicester, 2016.
Draper ES, K.J., Kenyon S (Eds) on behalf of MBRRACE-UK, MBRRACE-UK Perinatal Confidential Enquiry. Term, singleton, normally formed, antepartum stillbirth. Leicester: The Infant Mortality and Morbidity Studies, Department of Health Sciences, Univesity of Leicester. 2015.
Widdows K, Roberts SA, Camacho EM, Heazell AEP. Stillbirth rates, service outcomes and costs of implementing NHS England's Saving Babies' Lives care bundle in maternity units in England: A cohort study. PLoS One. 2021 Apr 19;16(4):e0250150. doi: 10.1371/journal.pone.0250150. eCollection 2021.
Gardosi J, Madurasinghe V, Williams M, Malik A, Francis A. Maternal and fetal risk factors for stillbirth: population based study. BMJ. 2013 Jan 24;346:f108. doi: 10.1136/bmj.f108.
Marufu TC, Ahankari A, Coleman T, Lewis S. Maternal smoking and the risk of still birth: systematic review and meta-analysis. BMC Public Health. 2015 Mar 13;15:239. doi: 10.1186/s12889-015-1552-5.
RCOG Green-Top Guideline 31: The Investigation and Management of the Small-for-Gestational Ages Fetus. Royal College of Obstetricians and Gynaecologists, 2013.
Alfirevic Z, Devane D, Gyte GM. Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour. Cochrane Database Syst Rev. 2006 Jul 19;(3):CD006066. doi: 10.1002/14651858.CD006066.
Widdows K, Reid HE, Roberts SA, Camacho EM, Heazell AEP. Saving babies' lives project impact and results evaluation (SPiRE): a mixed methodology study. BMC Pregnancy Childbirth. 2018 Jan 30;18(1):43. doi: 10.1186/s12884-018-1672-x.
Provided Documents
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Document Type: Study Protocol
Other Identifiers
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R04666
Identifier Type: -
Identifier Source: org_study_id
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