Education
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.
IMproving Perinatal and 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. With 5 training workshops undertaken to date, ANZSA, through its state based regional coordinators, aims to roll out this program across ANZ in the near future.
If you would like ANZSA to host an education session at your hospital please contact your relevant regional coordinator [link to regional coordinator page] at info@stillbirthalliance.org.au
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 families regarding autopsy
- Station Two: Placental and post mortem examination
- Station Three: Investigation of perinatal deaths
- Station Four: Examination of babies who die in the perinatal period
- Station Five: Perinatal mortality (PNM) classifications
- Station Six: Psychological and social aspects of perinatal bereavement
Station One
Communication with families regarding autopsy
Aim: To discuss communication and consent for perinatal postmortem (PM) with parents.
Objectives: At the end of this station you will
1. Understand the key principles regarding good communication in this setting
2. Understand the barriers to consent and discussion of PM
3. Be able to describe to families what actually happens at a PM.
Station Two
Placental and post mortem examination
Aim: To discuss the value, quality and standards of post mortem and placental examination and reporting.
Objectives: At the end of this station you will
1. Understand the value of post mortem examination
2. Be able to perform macroscopic and interpret microscopic examination of the placenta and cord
3. Identify and ensure quality and minimum standards for post mortem and placental examination and reporting
Station Three
Investigation of perinatal deaths
Aim: To describe the core investigations to be undertaken following a perinatal death.
Objectives: At the end of this station you will
1. Understand the timing, the type and the reasons for the core investigations for stillbirth, assisted by check lists
2. Understand extra targeted investigations for neonatal deaths
3. Provide alternative non invasive investigations where permission for autopsy is not obtained
Station Four
Examination of babies who die in the perinatal period
Aim: To demonstrate detailed clinical examination of babies including measurements and clinical photographs
Objectives: At the end of this station you will be able to
1. Use the recommended checklist for examination of perinatal deaths
2. Measure a baby and plot on Australian national birth weight percentiles
3. Perform recommended standardized clinical photographs
Station Five
Perinatal mortality (PNM) classifications
Aim: To provide an understanding of the purpose and approaches to PNM classification and how to use the PSANZ PNM classifications.
Objectives: At the end of this station you will have
1. Understood the advantages of the PSANZ PNM classification system in relation to other currently available systems
2. Know how to use the classification and identify the single most important factor that led to the perinatal death using the PSANZ Perinatal Death Classification for stillbirths and neonatal deaths and in addition the PSANZ Neonatal Death Classification for neonatal deaths.
3. Skills in practical application of the classification system by undertaking several practice examples with the tutor’s feedback
Station Six
Psychological and social aspects of perinatal bereavement
Aim: To summarise key recommendations of the guidelines concerning psychological and social aspects of perinatal bereavement.
Objectives:
1. Understand the range of responses and differences between bereaved parents and the impact of different cultural and religious practices
2. Know the factors considered to be important for bereaved parents which will influence their experience and outcome
3. Provide timely and appropriate information to parents concerning birth options, special circumstances, creating memories, hospital stay, funeral arrangements and aftercare
