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OASI Care Bundle Update, May 2017

OASI Update 5 - May 2017

Welcome to the OASI Care Bundle Update for May 2017. Thank you to Region 2 for their hard work setting up the project in their units. We look forward to supporting and working with you as well as hearing about how roll out is going.

It was great to see some of our Local Champions from Region 1 at the College on the day too. Thank you for taking the time to come and share your experiences with us and Region 2.

Region 3 will begin roll out in July and we are excited to announce that this will be ‘London and the East’:

  • Chelsea and Westminster
  • St Richard’s Hospital
  • Epsom General Hospital
  • Poole Hospital

We will work closely with them over the next two months to get their units set up and ready to begin roll out from 17 July 2017.


Update from the Project Team – The OASI Care Bundle online platform is LIVE!

The online platform is live! We have created an OASI Care Bundle discussion area within the new platform developed by the RCOG – Peer2Peer Groups. On this platform you will be able to:

  1. Ask questions directly to our Project Team (our Evaluation team and Clinical Leads) through online discussion groups
  2. Access training and promotional resources to download (videos and audio files will uploaded shortly following some work by the developers)

For those units who have begun roll out, you can join the group for your Region as well as the ‘All participating regions’ in which you will find training and promotional resources. For those units who have not begun roll out, you will be invited to join the ‘All participating regions’ group upon starting implementing the care bundle.

This is not intended as a resource to replace you getting in touch via email/phone about more immediate queries or any one-to-one discussions, but an opportunity to create discussion with other units as well as directly with other members of the project team and access the resources for the project. An email has been sent out to your Local Champions about how to sign up. Please get in touch with them should you want to join the discussions!


What the OASI Care Bundle project is not

  1. Funding the Local Champions
  2. Intended to restrict women’s movement and choices
  3. A research project


Funding the Local Champions. We are providing support through the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists through training and providing supporting materials. The Local Champions leading the project in each unit are doing so in their own time and in addition to their pre-existing clinical work.

Intended to restrict women’s movement and choices. A key element of the project involves encouraging clinicians to listen to the woman’s choice for position of birth. At the same time it is important that all clinicians keep the woman informed of risks related to her birth.

The project is not intending to prescribe a woman’s position for birth or restrict her movement. The aim is to evaluate how perineal trauma can be avoided. Clinicians can use the evidence to support and advise women about their choice of birth position. The care bundle interventions can be used with women in most positions. Ultimately, the choice is always the woman’s, armed with the best available information.

A research project. The OASI Care Bundle project is a Quality Improvement project. It is not an effectiveness trial of a simple intervention. Stepped Wedged Trials (SWTs) are pragmatic designs, commonly used to evaluate service delivery interventions bringing together evidence-based practice, implemented in a new setting/context. They are a study design option if the primary reason for rolling out the intervention is for the intervention to improve practice and if phased implementation is inevitable (Hargreaves et al. 2015).
The OASI Care Bundle brings together evidence based practice and does not contradict current NICE, or RCOG guidelines. It does not involve new or alternative treatments whose evaluation would almost always require an RCT design before scaling up implementation. Instead, the project aims to scale up and evaluate the effectiveness of the intervention in a new setting (UK), given the results from Norway and pilot studies in the UK.


Awareness – Walter C. Bornemeier, former President of the American Medical Association

 A quote from a former President of the American Medical Association: "No other muscle in the body is such a protector of the dignity"

"When compared to the hands the sphincter ani is far superior. If you place into your cupped hands a mixture of fluid, solid and gas and then, through an opening at the bottom try to let only the gas escape you will fail. Yet the sphincter ani can do it. The sphincter apparently can differentiate between solid, fluid, and gas. It apparently can tell whether the owner is alone or with someone, whether standing up or sitting down, whether its owner has his pants on or off. No other muscle in the body is such a protector of the dignity. A muscle like that is worth protecting."