We also discussed an exciting new initiative around improving experiences and outcomes for women whose pregnancy lasts beyond their due date and have planned to support this project as a forum during the next meetings. If you'd like to hear more about it then join us next time! :)

The MatNeo projects MEWS and ATAIN were discussed (see QI section) and there is opportunity for anyone interested to support this work :)

We learned about the successful work to improve the standard of bladder care - an amazing initiative with potential for All-Wales influence 👏

Merry Christmas everyone, see you in the new Year

The SNAP3 trial will carefully test if relaxing the ‘not a puff’ rule in three different ways could help pregnant women to quit or not.

The intervention will be delivered alongside standard NHS stop smoking support, and compared to standard support alone.

The trial is designed to be practical and run alongside ANY stop smoking support provided locally.

Please contact tracy.james@wales.nhs.uk if you would like further information.

We are looking for any member of staff with an interest in research to help promote and signpost people to the research team and/or our studies.

There will also be opportunities to become more involved and opportunities for training for anyone who is interested in this development.

If you’d like to find out more about the role or would be interested in taking on this role, please email Tracy James (Lead Midwife – Research Delivery) at  tracy.james@wales.nhs.uk

We discussed ideas around a clinic for women following an MLC pathway, when they reach 41 weeks, to try and reduce the likelihood of IOL at 40+12 (see QI section for more details on the discussions). It was agreed to put a post out to staff to gauge level of interest and explore more widely. It was suggested that anyone interested is encouraged to come to the next QI and research forum to plan.

Please contact Rebecca.Clement2@wales.nhs.uk for information about the research and QI forum

Please contact Tracy.James@wales.nhs.uk for information about the research midwife post.

MJ discussed her ideas around a clinic for women following an MLC pathway, when they reach 41 weeks, to try and reduce the likelihood of IOL at 40+12. MJ shared some examples she had explored from other areas including a ‘Chill clinic’ in Bristol that offers aromatherapy, biomechanics and good quality information. This clinic saw a reduction of 6% in people admitted for IOL.

The group were all very positive about the idea and all keen to help. MJ acknowledged that she has a busy workload/other commitment so would like it to be a shared project.

EM advised:

• A review of how many women following an MLC pathway are admitted monthly for IOL at 40+12, and how many people following MLC pathway go into spontaneous labour between 41 and 42 weeks.

• A cost analysis of potential savings with an estimated 6% reduction in IOL admission

• A draft of how the service could look considering staffing, options within the clinic, governance, competencies of staff to offer alternative therapies and the pathways/ guidelines around this.

• How the impact would be measured

It was agreed that MJ would put a post out to staff to gauge level of interest and explore more widely. It was suggested that anyone interested is encouraged to come to the next QI and research forum to plan.

EM agreed to draft a working document that can be developed through further discussion with a wider group.

All attendees felt very positive about the idea and want to support MJ to make it work.

We discussed QI work by an MCSW on the RCM leadership development course focusing on student midwives’ preparedness for theatre. This exciting project proposes that when student midwives have their MDU placement at ABUHB, they arrange a day to work alongside a MCSW who is covering theatres that day. It was agreed that members of the QI and research forum wil discuss this idea with the SMM team with the aim of trialing it in ABUHB with the potential to roll out as an All Wales initiative.

We also discussed the post-dates clinic which was introduced at the last Forum. We are pleased to announce that it has been re-named the "Almost There Club" and we are planning to pilot this idea at the Birth Centre in YYF from the Beginning of April 2024.

Full and productive discussions of these inspiring new projects we given priority in this month's forum. There are more detailed updates about both projects in the Qi section of this Padlet. Please check back next month for a research update or join us on the 12th April via Teams for our next meeting :)

If you'd like to support this brilliant project, please get in touch with Meg.

We'll continue to meet on the second Thursday of each month from 1-2pm. Teams links are available from rebecca.clement2@wales.nhs.uk so please get in touch if you'd like to join in.

• Chapter study are looking at a potential 3rd recruitment window in March which means that the research team will have increased visibility on B3 and opportunities for hospital staff to engage

• SNAP 3 smoking study is in set up with a proposed start date in April. Women will need 36/40 CO testing so research team will be do additional training for midwives in ANCs and community

• Research champions to be encouraged across all areas. Great opportunity to develop, expand CV and contribute to raising awareness of research. Some people already identified.

• There will be a 15-hour band 6 research post on TRAC soon and the attendees were asked to encourage anyone who may be interested to contact TJ

We had a research update (see the research section) and explored ways to improve recruitment onto the Giant Panda study.

The problem of women not feeling they are supported on the obstetric unit in techniques to promote physiological birth was raised. The group agreed that this would be a good problem to explore and added that some work was already underway to address this with some midwives undertaking a Biomechanics course.

The group agreed that it would be a good idea to explore all potential causes and solutions to this problem and formulate as a QI project. We plan to include a discussion of this problem on the agenda for May and aim to formulate a problem statement and brainstorm causes in order to complete a Fishbone and Pareto chart.

We had a brief summary of current progress on the MatNeo MEWS and ATAIN work.

MEWS: Baseline data from escalation survey obtained and shared with staff. B3 huddle happening regularly Monday-Friday and survey to collect staff feedback recently circulated.

ATAIN: Data collection method for Baby Care Bundle changed due to Badgernet introduction – currently exploring ways to optimise this process with Digital Lead Midwife. MatNeo champion to attend ATAIN meeting in CTM to learn about their process and consider whether any points could be adopted in ABUHB to improve our process.

Update on the Almost there Clinic was postponed until our next meeting.

If you would like to join the meeting in May, please contact rebecca.clement2@wales.nhs.uk for a Teams invite.

• LOCI – we’ve had our first babies born as a result of the trial 😊

• Giant Panda – we are still struggling to recruit to Giant panda. Any women/birthing people with any type of hypertension, up to 35+6/40 and medicated with one anti-hypertensive may be eligible. If anyone is admitted to triage or the ward, we’d greatly appreciate an email, we’ll come to GUH and approach the woman/birthing person if they are happy to discuss the trial with us, we’ll confirm eligibility with the doctor, ensure treatment chart and prescriptions are updated and collect any data required. Please email us on ABB.MidwiferyResearchTeam@wales.nhs.uk a simple ‘Potential Giant Panda Recruit and the ward area’ in the heading will suffice. There are also prizes for anyone who sends us a referral – Thank you!

Potential New Study

We are looking at the possibility of opening the CaPE trial, recruiting women/birthing people who are at increased risk of pre-eclampsia and randomising them to Calcium supplements or placebo.

We’re in the early stages of feasibility and will keep you updated.

Research Champions – we’re hoping this will be officially launched soon. As soon as it’s been authorised, I’ll email everyone who has shown an interest in the role to update them. There will be cohorts of recruits into this role, so if anyone else has an interest, please let me know.

Acknowledging that several interventions are already underway to improve this situation, the group recognised that an exploration of the potential causes may help identify other change ideas.

We explored the possible reasons as a group, utilising brainstorming and a MIRO board to facilitate participation. We grouped the idea together into themes:

• Environment

• Culture

• Education (Women and staff)

• Experience (Women and staff)

Current initiatives aim to address elements of education and environment and the group thought that change ideas to improve culture and experience could contribute to addressing this issue.

We planned to pick this theme up at the next meeting to identify other possible change ideas.

Following on from the discussion at last month’s Forum, we continued exploring the problem of some women feeling that physiological birth is not supported on LW.

Acknowledging that several interventions are already underway to improve this situation, the group recognised that an exploration of the potential causes may help identify other change ideas.

We explored the possible reasons as a group, utilising brainstorming and a MIRO board to facilitate participation. Further details and the MIRO board can be found in the QI section. We plan to continue exploring this theme at the next meeting (14th June, 1pm on Teams). Everyone welcome, please email rebecca.clement2@wales.nhs.uk for a link 😊

MJ expressed concern that attendance seems low and the group discussed ways to increase numbers attending.

Ideas included:

• An introductory call the day before the Clinic

• Posts about the positive feedback about the Clinic to be shared on ABUHB social media

• Changing the criteria to include OLC women

However, the group also highlighted that the Clinic has only been running for a few weeks and it will take time for CMWs to be reliably encouraging all eligible women to attend. MJ reassured and will also focus on promoting the message with current CMW team.

SNAP 3 study has been extended until 31/12/2025

TJ thanked the group for their collaboration around improving recruitment onto Giant Panda study. New poster for recruitment with QR code is under development which will bw distributed to all sites by the research team and communicated to CMWs.

Some of our studies are coming to an end or are in follow up and we are looking for new studies – if anyone sees anything they think may be of interest, please let us know – thank you.

We are continuing to look at improving the facilitation of physiological birth on the Labour Ward.

We had an update about the MatNeo MEWS project and the Team of the Shift Huddle which was introduced to Labour Ward on the 10th June and the progress that is being made with improving routine temperature monitoring of all babies within 2 hours of birth. You can see more info about these projects in the QI projects section.

We also had a research update from Tracy which you can read in full in the "Get involved in Research" section.

Our next forum will be held on Teams on the 8th August at 1pm. Please email Emma Mills for an invite :)

RCT, recruiting women/birthing people with any type of hypertension, up to 35+6/40 and medicated with one anti-hypertensive.

Randomisation is to either Labetalol or Nifedipine, women/birthing people can be starting or already taking medication.

Recruitment issues continue, but a big thank you to Leanne Ball-Davies who referred a potential participant via the QR code, we left a prize for her and hope she received it 😊

Staff posters with the QR code are in GUH, if a woman/birthing person is admitted with any type of hypertension, please scan and complete the form with the following information,

• The name of the midwife referring not the woman/birthing person’s name please.

• The location of the midwife – we will come to GUH and find you to ask for the details of the potential participant.

SNAP-3:

RCT, recruiting women/birthing people who smoke and are <25/40 pregnant.

Randomisation is to either usual care with the HMQ team or to the intervention delivered by the study office, using nicotine replacement in a different way.

Recruitment is going quite well, with fantastic support from the HMQ team, but we do have to speak to a lot of potential recruits in order to recruit one participant.

You may see posters in the ANCs with a QR code for more information, if potential participants ask about the trial, they can be directed to the QR code.

NCMH – Maternal Wellbeing:

National Centre for Mental Health are inviting women/birthing people to participate in a survey about their wellbeing during pregnancy and up to one year postnatal.

This study previously invited women/birthing people under the care of the perinatal mental health team to participate, but it’ll now be open to all.

Posters will be going up in ANC and there are postcards with a QR code so potential participants can access all the study information – we’re just waiting for the study office to confirm they can be put up.

LOCI

Fertility RCT – follow up continues, you may see participants who are participating in this trial.

CaPE – In Set up

RCT for women/birthing people who are at increased risk of pre-eclampsia.

Randomisation to Calcium supplements or placebo – this is a blinded trial.

Aiming to open at the beginning of August.

Potential Trials

PIONEER – RCT for women/birthing people who have risk factors for a pre-term birth.

BLUSH – RCT for women/people with VMS of the menopause.

New Role

The new research midwife vacancy is now being advertised on TRAC.

Closing date is 18/07/2024.

Vacancy is 37.5hrs with 30hrs considered, but all applications will be reviewed, even if you’d like less hours.

If anyone is interested and would like to find out more, please email me on tracy.james@wales.nhs.uk

As we have new colleagues joining us in August it will be even more important to hold a Huddle to ensure that every member of the team is familiar with their colleagues, know who to escalate to, improve situational awareness and provide support to each other. Let's Huddle!