Når avnavler jordmor i den normale fødsel, og hvilke kunnskapskilder støttes avnavlingstidspunkt på?

Abstract

Patient safety and quality in health care are prioritized areas both internationally, and nationally. The overall aim is that diagnosis and treatment should be based on research knowledge. However, studies show that practice does not always correspond with research-based knowledge, thus causing a gap between what we know and what we do. Research-based knowledge is important to ensure the quality of health services, and through the evaluation we gain knowledge of practice that enable us to assess if we are working evidence - based. The purpose of this quality improvement project was to document when midwifes clamp the umbilical cord in normal labour, in order to assess whether the practice corresponded with evidence-based standard. Clamping the umbilical cord in normal labour was studied through clinical audit. The first four steps in the audit circle were conducted. 112 midwives at a major birth clinic responded to a questionnaire regarding clamping of the umbilical cord, justification for the timing, placement of the child after birth and use of knowledge sources. The audit showed that 53 % of the midwifes clamped the umbilical cord in normal labour according to the evidence – based standard set for the audit. Furthermore, the audit showed that there were variations among midwives on when the clamping was performed. These variations where found both within the same ward and between the different maternity wards. The survey also showed that most midwives consulted with her colleague if they were facing a problem related to the timing of clamping the umbilical cord, few midwives used research-based knowledge. The timing of when the umbilical cord is clamped must be mediated to practice. By providing feedback from the audit midwifes can adjust their practice thus limiting the gap between what we know and what we do can be decreased.