Clinical Practice

IMPROVE

Through the Clinical Practice and Education Committee, ANZSA undertakes activities to improve clinical practice across maternity hospitals aimed at reducing stillbirth and providing optimal care for parents whose baby is stillborn.
 

The next IMPROVE workshop will be held in Toowoomba, QLD, on Saturday July 30th 2016. For more details please contact Eszter Katona (eszter.katona@mater.uq.edu.au). Please note this workshop is open to local staff only.

For details about other upcoming workshops for 2016, please contact Eszter Katona (eszter.katona@mater.uq.edu.au). More details will be posted here soon.



IMproving Perinatal mortality Review and Outcomes Via Education (IMPROVE) Workshops

Providing education for health care professionals on how to use the Perinatal Society of Australia and New Zealand's (PSANZ) Perinatal Mortality Guidelines is key to ensuring mothers and families receive the best care in the hospital setting. ANZSA in collaboration with the PSANZ Perinatal Mortality Group have developed an educational program for maternity health care professionals: IMproving Perinatal and Review and Outcomes Via Education (IMPROVE).

IMPROVE covers appropriate practices around principles of bereavement care, communicating with parents about autopsy, clinical examination, placental and post-mortem examination, investigation, classification, and audit of stillbirth.

If you would like ANZSA to host an education session at your hospital please contact your relevant regional coordinator.

Methodology:

IMPROVE uses a Structured, Clinical, Objective, Referenced, Problem-orientated, Integrated and Organised (SCORPIO) approach to teaching. SCORPIO is a medium for skills training based on small-group, participants centred, multi-professional teaching.

This method adapts the guidelines into six hands-on and dynamic rotating stations. Each station is based on a component of the guidelines: perinatal mortality classification, investigation, autopsy consent, placenta and post mortem examination, baby examination, and perinatal bereavement. The course is intended for the benefit of clinicians, obstetricians, pathologist, midwives, bereavement specialists: this is an opportunity for participants to understand the PSANZ PM Guidelines in an interactive way.

This interactive, small group, multi professional skills training course is designed to address the educational needs of all health professionals involved with child birth and early newborn care. The principle of incorporating best evidence content and using best evidence teaching methods is fundamental to the course design.

IMPROVE involves:

1. A short introductory lecture
2. Six teaching stations
3. Formative Assessment

Overview of the Teaching Stations

Station One
Communication with parents about perinatal autopsy


Aim: To provide information to assist clinicians to help parents make an informed choice about perinatal autopsy.
Objectives: At the end of this station you will

1. Understand the principles of compassionate communication around parental consent for autopsy.
2. Know the relevant information to provide parents to enable informed choice about perinatal autopsy including value of an autopsy. 
3. Understand the common barriers to obtaining consent for autopsy and be able to discuss possible solutions.

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Station Two
Autopsy and placental examination 


Aim: To describe the perinatal autopsy procedure and demonstrate the process of placental examination.
Objectives: At the end of this station participants will be able to:

1. Understand why placental examination and autopsy (even an external only) are so important in understanding why a baby has died.
2. Describe the procedures involved in perinatal autopsy and the appearance of a baby after an autopsy examination.
3. Perform a delivery unit examination of the placenta and cord to identify important abnormal features.

4. Understand when placental histopathology should be undertaken and how to transport placentae to the pathology department. 

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Station Three
Investigation of fetal deaths


Aim: To provide an understanding of the recommended investigations to identify the causes of fetal death.
Objectives: At the end of this station participants will be able to:

1. Explain the timing, type and reasons for the core investigations of a fetal death.
2. Explain the approach to investigating fetal death when the cause is definitely known.
3. Describe the timing, type and reasons for additional investigations of fetal death.

4. Explain alternative investigations and their availability for fetal death when autopsy is declined.

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Station Four
Examination of babies who die in the perinatal period


Aim: To demonstrate how to undertake a detailed clinical examination of stillbirths and neonatal deaths including measurements and clinical photographs.
Objectives: At the end of this station participants will be able to:

1. Explain how to take the recommended standardised clinical photographs of a deceased baby.
2. Accurately measure a baby's head circumference, length and weight and plot these measurements on centile charts.
3. Examine a deceased baby according to the recommended checklist.

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Station Five
Institutional perinatal mortality audit and classification 


Aim: To provide an understanding of the process of institutional perinatal mortality audit and classification as to causes and contributing factors of stillbirths and neonatal deaths.
Objectives: At the end of this station participants will be able to:

1. Explain the rationale for high quality perinatal mortality audit. 
2. Understand the rationale for classification using the PSANZ perinatal mortality classifications. 
3. Understand the principles of applying the PSANZ classification system for stillbirths and neonatal deaths.

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Station Six
Psychological and social aspects of perinatal bereavement


Aim: To provide an understanding of how to provide appropriate psychological and social support for famillies after a stillbirth and neonatal death. 
Objectives:

1. Understand parental responses after experiencing a perinatal death. 
2. List the factors considered to be important for bereaved parents which will influence their experience and outcome. 
3. Provide appropriate information to parents concerning birth options, special circumstances, creating memories, hospital stay, funeral arrangements and after care. 

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