{"title":"Validation of an Acuity Measurement Tool for Maternity Services","authors":"Cherryl Lowe","volume":101,"journal":"International Journal of Medical and Health Sciences","pagesStart":1417,"pagesEnd":1425,"ISSN":"1307-6892","URL":"https:\/\/publications.waset.org\/pdf\/10001188","abstract":"<p>Background - The TrendCare Patient Dependency<br \/>\r\nSystem is currently used by a large number of maternity Services<br \/>\r\nacross Australia, New Zealand and Singapore. In 2012, 2013 and<br \/>\r\n2014 validation studies were initiated in all three countries to validate<br \/>\r\nthe acuity tools used for women in labour, and postnatal mothers and<br \/>\r\nbabies. This paper will present the findings of the validation study.<br \/>\r\nAim - The aim of this study was to; identify if the care hours<br \/>\r\nprovided by the TrendCare acuity system was an accurate reflection<br \/>\r\nof the care required by women and babies; obtain evidence of<br \/>\r\nchanges required to acuity indicators and\/or category timings to<br \/>\r\nensure the TrendCare acuity system remains reliable and valid across<br \/>\r\na range of maternity care models in three countries.<br \/>\r\nMethod - A non-experimental action research methodology was<br \/>\r\nused across maternity services in four District Health Boards in New<br \/>\r\nZealand, a large tertiary and a large secondary maternity service in<br \/>\r\nSingapore and a large public maternity service in Australia.<br \/>\r\nStandardised data collection forms and timing devices were used to<br \/>\r\ncollect midwife contact times, with women and babies included in the<br \/>\r\nstudy. Rejection processes excluded samples when care was not<br \/>\r\ncompleted\/rationed, and contact timing forms were incomplete. The<br \/>\r\nvariances between actual timed midwife\/mother\/baby contact and the<br \/>\r\nTrendCare acuity category times were identified and investigated.<br \/>\r\nResults - Thirty two (88.9%) of the 36 TrendCare acuity category<br \/>\r\ntimings, fell within the variance tolerance levels when compared to<br \/>\r\nthe actual timings recorded for midwifery care. Four (11.1%)<br \/>\r\nTrendCare categories provided less minutes of care than the actual<br \/>\r\ntimings and exceeded the variance tolerance level. These were all<br \/>\r\nnight shift category timings. Nine postnatal categories were not able<br \/>\r\nto be compared as the sample size for these categories was<br \/>\r\nstatistically insignificant. 100% of labour ward TrendCare categories<br \/>\r\nmatched actual timings for midwifery care, all falling within the<br \/>\r\nvariance tolerance levels.<br \/>\r\nThe actual time provided by core midwifery staff to assist lead<br \/>\r\nmaternity carer (LMC) midwives in New Zealand labour wards<br \/>\r\nshowed a significant deviation to previous studies. The findings of<br \/>\r\nthe study demonstrated the need for additional time allocations in<br \/>\r\nTrendCare to accommodate an increased level of assistance given to<br \/>\r\nLMC midwives.<br \/>\r\nConclusion - The results demonstrated the importance of regularly<br \/>\r\nvalidating the TrendCare category timings with actual timings of the<br \/>\r\ncare hours provided. It was evident from the findings that variances<br \/>\r\nto models of care and length of stay in maternity units have increased<br \/>\r\nmidwifery workloads on the night shift. The level of assistance<br \/>\r\nprovided by the core labour ward staff to the LMC midwife has<br \/>\r\nincreased substantially.<br \/>\r\nOutcomes - As a consequence of this study, changes were made to<br \/>\r\nthe night duty TrendCare maternity categories, additional acuity<br \/>\r\nindicators were developed and times for assisting LMC midwives in<br \/>\r\nlabour ward increased. The updated TrendCare version was delivered<br \/>\r\nto maternity services in 2014.<\/p>\r\n","references":"[1] M.A. Blegen, C.J. Goode, I. Reed, \u201cNursing Staffing and Patient\r\nOutcomes\u201d, Journal of Nursing Research, Vol. 4, No. 7, pp 43-50, 1998.\r\n[2] K.M. Parrinello, \u201cAccounting for Patient Acuity in an Ambulatory\r\nSurgery Centre\u201d, Journal of Nursing Economics, Vol. 5, No. 4, pp 167-\r\n172, 1987.\r\n[3] K. Harper, C. McCully, \u201cAcuity Systems Dialogue and Patient\r\nClassification System Essentials\u201d, Journal of Nursing Administration,\r\nVol. 31, No. 4, pp 248-299, 2007.\r\n[4] V. Plummer, \u201cAn Analysis of Patient Dependency Data Utilizing the\r\nTrendCare System,\u201d Doctoral thesis, Monash University, Melbourne,\r\nAustralia 2005.\r\n[5] E.J.S. Hovenga, \u201cDevelopment of the Patient Assessment and\r\nInformation System (PAIS), Doctoral thesis, University of New South\r\nWales, 1994.\r\n[6] J.D. Thompson, \u201cThe Measurement of Nursing Intensity\u201d, Health Care\r\nFinancing Review, Nov. Annual Supplement No. 6 pp 47-55, 1984.\r\n[7] A.R. Gault, \u201cThe Aberdeen Formula as an Illustration of the Difficulty\r\nof Determining Nursing Requirements\u201d, International Journal of Nursing\r\nStudies, Vol. 19, pp 61-77, 1982.","publisher":"World Academy of Science, Engineering and Technology","index":"Open Science Index 101, 2015"}