Hi Claire and the rest,
Another argument that could be added against the introduction of “fresh ears” is to state briefly what are the main/common errors in IA and say that sometimes errors in IA come from clinicians who mix up how to interpret a CTG with how to perform IA, especially in units where the percentage of women on CTGs is much greater than IA.
In my clinical practice I have seen written in several occasions things like FHR between 140-150, instead of a single number, for example, 144bpm ,or things like good variability heard or accelerations/no decelerations, Fetal heart rate being auscultated during a contraction to see if there are early decelerations
These are features of CTG interpretation not IA...
By adding now a “fresh ears” approach it can confuse clinicians further, because in essence we are trying to put a feature of CTG monitoring into IA rather than a safety measure unique or relevant to IA.
I think the answer is to create stronger training programs in IA and definitely more research into IA to find out what the optimum approaches to this type of monitoring are, in order to make IA more robust.
Best wishes
Lucia
> On 26 Feb 2020, at 21:13, Robyn Maude <[log in to unmask]> wrote:
>
> Hi Claire and Others,
>
> I have been following this thread with interest and agree wholeheartedly with the comments and thoughts of everyone. I am concerned this nonsense will make its way to us Downunder in time, so it is great to be forewarned so we can armed ready for this.
>
> Midwives who use IA in everyday practice are skilled at interpreting what they hear and taking appropriate action (normally). Using a decision-making framework, such as ISIA (which can be modified to reflect local guidelines) provides midwives with a robust means of demonstrating their critical thinking and clinical reasoning when using IA (Maude, R., Foureur, M., & Skinner, J. 2016. Putting intelligent structured intermittent auscultation (ISIA) into practice. Women and Birth, 29, pp. 285-292. DOI information: 10.1016/j.wombi.2015.12.001. http://dx.doi.org/10.1016/j.wombi.2015.12.0013.)
>
> I think it is vitally important to teach IA in undergraduate midwifery education and to expose students to the practice of IA in their clinical learning experiences. Indeed, I think the same applies for our medical colleagues who work in intrapartum care.
>
> Thank you for bringing this issue to our attention. If it is of any use, I am happy to add my name to your letter.
>
> Cheers, Robyn
>
> Associate Professor Robyn Maude JP PhD MA (Midwifery), BN, RM, RN, PGCHLT
> Head of Programme for Midwifery | Pouakorangi Tikanga Wakawhānau
> Samoan Grow Our Own Nursing and Midwifery Programme Lead
> School of Nursing, Midwifery, and Health Practice| Te Kura Tapuhi Hauora
> Faculty of Health| Te Wāhanga Tātai Hauora
> Victoria University of Wellington | Te Whare Wānanga o Te Ūpoko o te Ika a Māui
> PO Box 7625 Newtown | Pouaka Poutāpeta 7625
> Wellington | Te Whanganui-a-Tara
> Phone | Waea +64-4 463 6137
> Mobile | Waea Pūkoro +64 (0) 274 793 826
> Email | Īmera [log in to unmask]
>
>
> -----Original Message-----
> From: A forum for discussion on midwifery and reproductive health research. <[log in to unmask]> On Behalf Of Claire Feeley
> Sent: Wednesday, 26 February 2020 3:46 AM
> To: [log in to unmask]
> Subject: Re: 'Fresh ears'
>
>
> Much appreciated Soo! I'd started tweaking too...why does it always look different once you've hit send??!!
> Claire On Tuesday, 25 February 2020, 14:33:46 GMT, Soo Downe <[log in to unmask]> wrote:
>
> Hi Claire and all!
>
> Many thanks for doing this Claire - as is my wont (as you know!) I have made some suggested changes - see what you and others think
>
> Im happy to sign it
>
> All the best
> soo
>
> -----Original Message-----
> From: A forum for discussion on midwifery and reproductive health research.
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