Getting evidence into obstetric and midwifery practice: reducing perineal trauma

Michael C Nicholl, Miriam A Cattell
2006 Australian Health Review  
Problem: Frequent obstetric perineal morbidity in a hospital setting with service providers inexperienced in getting evidence into practice. Design: Clinical practice improvement methodology in a tertiary referral obstetric unit. Strategies for change: To cease active instruction to push in the second stage of labour; encourage the adoption of the left lateral position when delivering on a bed; use of the vacuum extractor rather than forceps where instrumental delivery indicated. Effects of
more » ... ge: Improved perineal outcomes with a 21.5% increase in intact perineum rate and a 100% reduction in fourth degree perineal tears. Lessons learned: Clinical practice improvement methodology is a useful tool for getting evidence into practice, resulting in improved clinical out-Aust Health Rev 2006: 30(4): 462-467 comes.
doi:10.1071/ah060462 pmid:17073541 fatcat:pamph46b4jctnpzowqhqxrx6h4