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OASI Care Bundle Update, April 2017

OASI Update 4 - April 2017

Welcome to the OASI Care Bundle Update for April 2017. We are excited to begin roll-out with Region 2 over the coming months. Thank you to our first participating sites in Region 1 for their commitment and hard work over the last 5 months, we look forward to continuing working with you.

From the Project Team

We are coming to the end of the 3 month roll-out period for Region 1 and have seen some fantastic progress. A huge number of Obstetricians and Midwives have been trained and there is widespread awareness of the project in the units. This is testament to the Local Champions who have done an enormous amount of work setting up the project in their units and cascading training in the care bundle interventions to their colleagues. We will continue to support and work with the units in Region 1 over the coming months.

We hope that Region 1 will provide valuable first-hand insight and experience of the project for Region 2. From 24th April, Region 2 will begin rolling out the care bundle within their units and we have been working with them over the past two months to set up the project. The units in Region 2 are:

  • Bedford Hospital
  • Milton Keynes Hospital
  • Calderdale Royal Hospital
  • Nottingham City Hospital

Louise Taylor, Local Midwifery Champion – Royal Gwent Hospital

What a busy three months we have had in Newport. Introducing and rolling out the OASI Care Bundle has been a great opportunity for catching up with midwives and doctors I have either not met before or haven’t seen in a while. The care bundle has been met with great enthusiasm by the staff on the whole and has caused some of us to question the way we were trained to do things; delivery of the shoulders being the most obvious change for us. As confidence in the techniques has increased, we are starting to see the benefits.

As with all roll outs there are some frustrations. Getting around all of the midwives and doctors to deliver the training has been challenging and they do keep moving around! The training is simple to deliver and my advice to new sites coming into the evaluation would be to identify your champions early on and share the workload. Another challenge for us has been getting the monitoring questions right on the maternity database, so that weekly reports can be generated with ease. Now that things are up and running, it has been really useful to be able to monitor eligibility and compliance over the roll-out period.

The resources and training that the OASI team provide are really helpful and it has been a useful update for midwives and doctors in relation to vaginal and rectal examination and assessment of degree of tearing. Good luck to the new centres coming on board this month!

Awareness – Karen’s story

It all started in October 2010; I went into labour with my first child after an uneventful pregnancy.  I was 30, fit, sporty, healthy and excited. 

Labour progressed well, I got to 9.5cms and my baby became distressed so a forceps delivery was initiated.

I had an episiotomy, forceps were introduced and Freya was born.  Sadly I was inadequately assessed by the obstetrician post-delivery and my grade 4 tear was undiagnosed and only the superficial skin on my perineum was sutured.

5 days later, in a lot of pain and passing flatus and faeces per vagina, I was re-admitted to the hospital I delivered in.  A traumatic cloacal injury was diagnosed and I had developed a 5cm recto-vaginal fistula.  I was then transferred to a specialist hospital for a secondary sphincter repair.

I spent 6 days in hospital, on bed rest followed by 8 weeks of further bed rest at home, which resulted in social isolation and depression.  I couldn’t sit until Christmas 2010. 

With the support of my fabulous husband, I went on to have a second child by caesarean section. 

Today I have on-going issues with dyspareunia, faecal incontinence, rectal and abdominal pain and am developing symptoms of a prolapse.  I am lucky that with the help of painkillers and a strict diet, I can now ride horses, play netball and have eventually re-gained my social life, sense of humour and smile.