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Created on : 28 Oct 2004
Modified on : 02 Dec 2007

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Bibliographical entry (without author) :

The impact of national clinical guidelines on obstetricians in Scotland. Health-Bull-(Edinb). 2001 Nov; 59(6): 364-72

Author(s) :

Foy,-R; Penney,-G; Greer,-I

Year of publication :

2001

URL(s) :

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=…

Résumé (français)  :

Abstract (English)  :

OBJECTIVE: To audit reported clinical practice in relation to four national obstetric guidelines on The Preparation of the Foetus for Preterm Delivery, The Management of Mild, Non-proteinuric Hypertension in Pregnancy, The Management of Pregnancy in Women with Epilepsy and The Management of Postpartum Haemorrhage.

DESIGN: Questionnaire surveys before and after dissemination of the guidelines.

SUBJECTS: One hundred and sixty one consultants and senior specialist registrars in Scotland.

RESULTS: The response rates to the baseline and follow-up surveys were 85% and 74% respectively. Over 90% of the obstetricians kept the guidelines for reference and 85% had been prompted to change or reconsider their practice. Reported compliance improved significantly for six out of twenty nine recommendations covering: the use of tocolysis in women at risk of pre-term labour; the use of prophylactic antibiotics or entry to a clinical trial for pre-term, pre-labour rupture of the membranes; the initiation of steroid therapy in women with insulin-dependent diabetes mellitus; and the prescribing of periconceptual folic acid and vitamin K to women with epilepsy. There were no significant improvements in relation to mild, non-proteinuric hypertension or post-partum haemorrhage.

CONCLUSIONS: There were significant improvements in the reported management of women at risk of preterm labour and those with epilepsy. However, reported practice in relation to mild, non-proteinuric hypertension and post-partum haemorrhage has improved little. This is possibly because the guidelines for these topics were relatively complicated to understand and apply, and established patterns of practice more resistant to change.

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Keywords :

➡ guidelines ; premature baby ; postpartum hemorrhage ; informed consent

Author of this record :

Bernard Bel — 28 Oct 2004
➡ latest update : Bernard Bel — 02 Dec 2007