community midwife equipment list clinical guideline v2.0 july … · 2019-07-22 · community...

Community Midwife Equipment List Clinical Guideline

V2.0

July 2019

Community Midwife Equipment List Clinical Guideline V2.0 of 17

1. Aim/Purpose of this Guideline 1.1. To provide community midwives with a list of equipment that they should carry individually and the availability of additional equipment. This should be carried in the standardised bag provided by the trust New 2018 1.2. This version supersedes any previous versions of this document.

1.3. Data Protection Act 2018 (General Data Protection Regulation – GDPR) Legislation The Trust has a duty under the DPA18 to ensure that there is a valid legal basis to process personal and sensitive data. The legal basis for processing must be identified and documented before the processing begins. In many cases we may need consent; this must be explicit, informed and documented. We can’t rely on Opt out, it must be Opt in.

DPA18 is applicable to all staff; this includes those working as contractors and providers of services.

For more information about your obligations under the DPA18 please see the ‘information use framework policy’, or contact the Information Governance Team [email protected]

2. The Guidance 2.1. Antenatal/Postnatal Bag contents

Neonatal electronic thermometer

C02 monitor

Intrapartum transfer forms

SBARD stickers

Sphygmomanometer

Stethoscope

Urine testing sticks (COMBU7)

2 x MRSA screening swabs

Pinard stethoscope/sonic aid and gel

Venepuncture equipment/forms

Cannulation equipment

IV administration set (also for cord prolapse management)

Swabs for microbiology

MSU pots/none MSU urine pots

Disposable towels

Disposable gloves - latex - non sterile/sterile

Disposable syringes, needles,

Disposable speculum

Glycerine suppositories/enemas

Newborn screening equipment

Cord clamp

Sharps bin

KY Jelly - sterile sachet

Laerdal masks - adult


Disposable tape measure

Appropriate documentation

Cutan hand cleaner

Large BP Cuff (may be shared between team)

2.2. Birth Equipment

Delivery pack

Red linen bag and liner – (If appropriate)

Perineal repair pack -RCHT packs incl with Delivery

20ml syringes

Green needles

Suturing material (Vicryl 2.0)

Raytec swabs

Disposable airways 000, 00, 0

Disposable Ambubag (500 ml reservoir)

Cord clamps

Hat

Laryngoscope/tongue depressors

Adult non re breathe mask

Adult size guedel

Entonox equipment plus disposable mouthpiece

Bladder filling equipment - Foley’s catheter,

2x 500 mls iv infusion 0.9% Sodium Chloride (to be used iv or to fill the bladder) (New 2019)

IV giving set

Catheterisation Pack, In/out catheter

Instilligel

Amnihook

Cannulation equipment

Needles and syringes

Sanitary pads and swabs

Disposable Aprons

Clinical waste bags and ties

Sterile gloves

Non sterile glove

Amnihook

Goggles

Placenta box, Daniels placenta bag

Yellow clinical waste bags

Appropriate documentation i.e. proformas, Pause sticker

Entonox equipment plus disposable mouthpiece

Scales/alcohol wipes

Spare batteries for sonicaid and scales

2.3. Drugs

Syntocinon 5iu/ml x 2 (to be changed 2 monthly)

Ergometrine 500mcgs x 2 (to be changed 2 monthly)

Lidocaine 1%/10mls x 2

Vitamin K 1mg x 2 including oral syringes


Adrenalin pack from pharmacy

1 Litre saline 0.9% (for IV fluids/bladder filling)(New 2019)

Misoprostol (See PGD in midwives shared folder) See appendix 3 for Audit form New 2018

2.4. Maintenance

It is each midwives responsibility to ensure that their bags are kept clean, tidy and fully stocked up and all drugs and equipment are in date.

The intrapartum ‘grab bag’ should be checked and restocked after each transfer and also on a weekly basis.

Six monthly checks of entonox equipment and scales.

Two yearly check of sphygmomanometer.

Sonicaid to be checked as and when necessary.

2.5. Intrapartum transfer equipment Grab bags: All birth centers should have a ‘grab bag’ which should be used for all intrapartum transfers to the acute unit, and should contain:

Delivery pack with cord clamp

Pack of swabs

Towels for the baby

Maternity pads

Nappy

Hat for the baby

Neonatal bag and mask

Guedal air way

Syntocinon 5iu/ml

Sonicaid

Syringes and needles

2.6. Community midwife homebirth bag standardised packing instructions (New 2018)

This is the front of the bag (front pocket has clear pouch).


In the large zipped pocket to the front of your bag please place your neonatal equipment: mask, guedel airways (000,00 and 0) and any extras such as cord clamps, a hat and a laryngoscope with blades if you use one. You should also place your emergency adrenaline pack in here. New 2018

Left hand side pocket of the bag new 2018

In this pocket please place your suturing equipment. 20ml syringes, green needles, suturing material (vicryl 2.0) and lidocaine. New 2018


Right hand pocket of the bag, In this pocket we have the adult resus equipment and Entonox mouthpiece. A non-re-breathe mask and adult size guedel airway. New 2018


In this pocket we have bladder filling equipment including a foleys catheter and catheter bag which can be used for standard catheterisation. New 2018

Top pocket of the bag. New 2018 In here we have documentation and spare batteries New 2018


Main body of the bag. New 2018

In the top, clear pocket there are needles, syringes, drugs and cannulation equipment. New 2018


In the main part of the bag: at the top we have a compartment for ‘procedures, there is a catheterisation pack, in-out catheter, Instilliagel, Amnihook, 0.9% sodium chloride 1000ml and a IV giving set in here along with disinfectant wipes. In the lower part in each compartment from left to right there are: 1) Waste bags (black, orange, yellow, and linen), cable ties, plastic sheet 2) Sanitary pads and swabs 3) PPE - gloves (both sterile and non-sterile), aprons and goggles

We then have a placenta pot with a lid below filled with inco pads. New 2018

Below is the ‘procedures’ compartment in more detail


Place your delivery pack on the top (ours is in the blue bag). New 2018

Images - Copyright Royal Cornwall Hospitals Trust 2018

2.7. Intrapartum transfer from a home birth: Any community midwife undertaking an intrapartum transfer from a home birth must ensure that they have all equipment that may be required during the transfer, with them during the transfer. This must include all equipment listed above.


3. Monitoring compliance and effectiveness

Element to be monitored

Weekly checking of ‘grab bags’ Entonox equipment checks

Lead Community Team Leaders

Tool Completion of check lists Records of entonox checks

Frequency As required

Reporting arrangements

Through Community Team Leaders

Acting on recommendations and Lead(s)

Team leaders to take appropriate action

Change in practice and lessons to be shared

Through Team Leaders Forum

4. Equality and Diversity 4.1. This document complies with the Royal Cornwall Hospitals NHS Trust service Equality and Diversity statement which can be found in the 'Equality, Inclusion & Human Rights Policy' or the Equality and Diversity website.

4.2. Equality Impact Assessment

The Initial Equality Impact Assessment Screening Form is at Appendix 2.

http://www.rcht.nhs.uk/GET/d10268876

http://www.rcht.nhs.uk/GET/d10268876

http://intranet-rcht.cornwall.nhs.uk/shelf/equality-and-diversity/


Appendix 1. Governance Information

Document Title Community Midwife Equipment List Clinical Guideline V2.0

Date Issued/Approved: 4th July 2019

Date Valid From: July PRG

Date Valid To: July 2022

Directorate / Department responsible (author/owner):

Trudie Roberts, Community Matron Obs and Gynae Directorate

Contact details: 01872 252270

Brief summary of contents

To provide community midwives with a list of equipment that they should carry individually and the availability of additional equipment

Suggested Keywords: VTE, risk, assessment, venous, thromboprophylaxis, Fragmin, TEDS

Target Audience RCHT CFT KCCG

Executive Director responsible for Policy:

Medical Director

Date revised: 4th July 2019

This document replaces (exact title of previous version):

Community Midwifery Equipment – Clinical Guideline V1.4

Approval route (names of committees)/consultation:

Clinical Guidelines Group Maternity Governance Obstetrics and Gynaecology Directorate Policy Review group Divisional Board for approval

Care Group General Manager confirming approval processes

Debra Shields, Care Group Manager

Name and Post Title of additional signatories

Not required

Name and Signature of Care Group/Directorate Governance Lead confirming approval by specialty and care group management meetings

{Original Copy Signed}

Name: Caroline Amukusana

Signature of Executive Director giving approval

{Original Copy Signed}


Publication Location (refer to Policy on Policies – Approvals and Ratification):

Internet & Intranet Intranet Only

Document Library Folder/Sub Folder Clinical/Midwifery and Obstetrics

Links to key external standards None required

Related Documents: None

Training Need Identified? No

Version Control Table

Date Version

No Summary of Changes

Changes Made by (Name and Job Title)

2003 V1.0 Initial version Jan Clarkson Community midwife

2010 V1.1 Updated Jan Clarkson Maternity risk manager

1 Nov 13 V1.2 Updated and added intrapartum grab bag for birth centres

Jan Clarkson Maternity risk manager

1.9.2016 V1.3

Updated to include neonatal thermometer, C02 monitor, intrapartum transfer form and SBARD sticker, IV administration and bladder filling equipment

Community Team Leaders and Rob Holmes, Consultant Obstetrician, Obs & Gynae Directorate

7th June 2018

V1.4

Updated to include section 2.6 - photos of new community bag and packing schedule and addition of Appendix 3 Misoprostol order sheet.

Trudie Roberts, Community matron, Charlotte Boswell and Lizzie Anstey, community midwives

4th July 2019

V1.5 Updated to change the amount of sodium carried for bladder re-filling and IV infusion.

Rob Holmes, Consultant Obstetrician, Obs & Gynae Directorate

All or part of this document can be released under the Freedom of Information

Act 2000

This document is to be retained for 10 years from the date of expiry. This document is only valid on the day of printing

Controlled Document

This document has been created following the Royal Cornwall Hospitals NHS Trust Policy for the Development and Management of Knowledge, Procedural and Web

Documents (The Policy on Policies). It should not be altered in any way without the express permission of the author or their Line Manager.


Appendix 2. Initial Equality Impact Assessment Form

Name of the strategy / policy /proposal / service function to be assessed

Community Midwife Equipment List Clinical Guideline V2.0

Directorate and service area: Obs & Gynae Directorate

New or existing document: Existing

Name of individual completing assessment: Trudie Roberts

Telephone: 01872 252684

1. Policy Aim* Who is the strategy / policy / proposal / service function aimed at?

To provide community midwives with a list of equipment that they should carry individually and the availability of additional equipment.

2. Policy Objectives*

To ensure community midwives have up to date equipment which is in good working order

3. Policy – intended Outcomes*

Ensure equipment is available as required

4. *How will you measure the outcome?

Compliance monitoring tool

5. Who is intended to benefit from the policy?

Pregnant, labouring and post-natal women

6a Who did you consult with b). Please identify the groups who have been consulted about this procedure.

Workforce Patients Local groups

External organisations

Other

x

Clinical Guidelines Group Maternity Governance Obstetrics and Gynaecology Directorate Policy Review group Divisional Board for approval

What was the outcome of the consultation?

Guideline agreed


Are there concerns that the policy could have differential impact on:

Equality Strands: Yes No Unsure Rationale for Assessment / Existing Evidence

Age x

Sex (male,

female, trans-gender / gender reassignment)

x

Race / Ethnic communities /groups

x

Disability - Learning disability, physical impairment, sensory impairment, mental health conditions and some long term health conditions.

x

Religion / other beliefs

x

Marriage and Civil partnership

x

Pregnancy and maternity

x

Sexual Orientation, Bisexual, Gay, heterosexual, Lesbian

x

You will need to continue to a full Equality Impact Assessment if the following have been highlighted:

You have ticked “Yes” in any column above and

No consultation or evidence of there being consultation- this excludes any policies which have been identified as not requiring consultation. or

Major this relates to service redesign or development

8. Please indicate if a full equality analysis is recommended. Yes No x

9. If you are not recommending a Full Impact assessment please explain why.

Not indicated

7. The Impact Please complete the following table. If you are unsure/don’t know if there is a negative impact you need to repeat the consultation step.


Date of completion and submission

4th July 2019

Members approving screening assessment

Policy Review Group (PRG) APPROVED

This EIA will not be uploaded to the Trust website without the approval of the Policy Review Group. A summary of the results will be published on the Trust’s web site.


Appendix 3 (New 2018)

Misoprostol 200mcg tablets Community Midwives order sheet.

Date

Drug

Strength

Volume

Ordered by

Dispensed by Print

Dispensed by Signed

Received by Print

Received by Print

Given to Print or patient label

Strength given

Given by Print

Given by Sign

On what date

Emergency pharmaceutical treatment of postpartum haemorrhage in the community setting

First line Second Line Third Line

Syntometrine 500mcg Ergometrine with 5 units oxytocin. IM OR

Ergometrine 500mcg Im Misoprostol 800mcg PR

Oxytocin 10 units IM (raised BP)