Clinical Practice
Through the Clinical Practice and Education Committee, ANZSA undertakes
activities to improve clinical practice across maternity hospitals. These
activities aim to reduce stillbirth and provide optimal care for parents whose
baby is stillborn.
The Clinical Practice and Education Committee terms
of reference outlines why this committee was established.
The primary clinical practice initiatives underway currently are :
Implementation of the Perinatal Society of Australia and New Zealand
Guidelines for Perinatal Mortality
While there are still high rates of stillbirth in Australia and New Zealand, up
until 2004 there were no uniform process for audit, investigation or review in
maternity hospitals. The inconsistencies in investigation hindered the
identification of preventable causes and limited the ability to reduce perinatal
mortality rates. Such deficiencies led the Perinatal Mortality Group of the
Perinatal Society of Australia and New Zealand to develop
clinical practice guidelines
for perinatal mortality audit. The PSANZ Guidelines were initially developed
in 2004 and revised in April 2009 to provide guidance for maternity care
clinicians in areas of:
- institutional perinatal mortality audit
- psychological and social aspects of perinatal bereavement
- perinatal post-mortem examination
- investigation of stillbirths
- investigation of neonatal deaths
- perinatal mortality classifications
In 2007, a telephone survey of senior midwives and doctors in birth suites
across Australia and New Zealand found low awareness of the PSANZ Guidelines and
less than optimal uptake of the recommendations into practice. Further, the lack
of uptake is evident in the very low perinatal autopsy rates across ANZ. A
survey of perinatal committees in 2008 showed that autopsy rates reported by 8
regions range from 61.2 % and 30.7 %.
An active implementation program has now been developed and funds are being
sought across a number of States and Territories for rollout through
regional coordinators. The program includes and
educational program for health care providers on the PSANZ Guidelines IMPROVE (IMproving
Perinatal Review and Outcomes Via Education) which utilised the SCORPIO method
of teaching; an E-learning program based on IMPROVE;
and a clinical data collection tool for perinatal mortality audit since
developed by ANZSA and the PSANZ PMG.
Development of new clinical practice guidelines
A number of new guidelines are being developed including: The management of
women with decreased fetal movements; and Antenatal detection and management of
fetal growth restriction.
The members of the ANZSA Clinical Practice and Education Committee are:
A/Prof Adrian Charles Regional Coordinator WA Dr Vicki Culling Regional Coordinator NZ Dr Amanda Dennis Regional Coordinator TAS Prof David Ellwood Regional Coordinator ACT A/Prof Vicki Flenady Regional Coordinator QLD Prof Heather Jeffery Regional Coordinator NSW Ms Belinda Jennings Committee member Prof Yee Khong Regional Coordinator SA Dr Kassam Mahomed Committee member Ms Tomasina Stacey Regional Coordinator NZ A/Prof Glyn Teale Regional Coordinator VIC Dr Sujatha Thomas Regional Coordinator NT Ms Julie Wheeler Committee member Ms Trish Wilson Committee member