Women’s and Children’s Health
CHILDBIRTH
COMMUNIQUE
OCTOBER 2011
CANTERBURY HEALTH LABORATORIES MAPS...........................................................................2
MESSAGE FROM SAM BURKE......................................................................................................3
NZCOM MEETINGS.........................................................................................................................3
BIRTHING SUITE NEWS..................................................................................................................4
NEWS FROM RANGIORA HOSPITAL.............................................................................................6
BURWOOD BIRTHING UNIT – THE PLACE OF “BEAUTIFUL BABIES”........................................7
NEWS FROM LINCOLN...................................................................................................................8
IMPROVING THE CONTINUITY OF CARE FOR PREGNANT WOMEN
WITH HIGH NEEDS.......................................................................................................................10
NEWS FROM LACTATION CONSULTANTS..................................................................................11
MIDWIFERY EDUCATORS UPDATE.............................................................................................12
ANTENATAL HIV SCREENING PROGRAMME UPDATE..............................................................15
UNIVERSAL NEWBORN HEARING SCREENING AND
EARLY INTERVENTION PROGRAMME........................................................................................16
NEONATAL TRANSPORT UPDATE...............................................................................................18
NEONATAL BCG VACCINATION...................................................................................................18
INTRA-UTERINE FETAL PROGRAMMING: INCREASING THE RISKS
OF OBESITY AND TYPE 2 DIABETES IN THE NEXT GENERATION...........................................20
SAFETY & QUALITY UNIT.............................................................................................................22
FIVE MOMENTS – IT’S COMING, GET READY!...........................................................................23
A CLINICAL AUDIT OF RHD IMMUNOGLOBULIN IN NEW ZEALAND.......................................24
MIDWIFERY LIAISON ROLE FOR 5TH YEAR MEDICAL STUDENTS..........................................26
PERINATAL AND MATERNAL MORTALITY REVIEW COMMITTEE.............................................27
PHYSIOTHERAPY UPDATE..........................................................................................................29
SOCIAL WORK SERVICE AT CHRISTCHURCH WOMEN’S HOSPITAL......................................30
CANTERBURY HEALTH LABORATORIES WEB RESOURCES....................................................32
HOSPITAL PARKING UPDATE......................................................................................................33
MEMO FROM NZ BLOOD.............................................................................................................34
ELECTRONIC CORRESPONDENCE FROM
CHRISTCHURCH WOMEN’S HOSPITAL......................................................................................35
FEEDBACK....................................................................................................................................36
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COMPILED BY STAFF OF THE WOMEN’S HEALTH DIVISION
With special thanks to:
• All contributors for sharing of information and items of interest.
•Canterbury Health Laboratories for their sponsorship of the Childbirth
Communiqué.
Sponsored by
Canterbury Health Laboratories
MESSAGE FROM SAM BURKE
Spring is here. It has seemed like a long winter but we can look forward to lighter,
warmer evenings in the near future.
I hope you find this edition informative and interesting, and thank you as always for
the hard work and great contributions to this edition.
We have our next LMC forum scheduled for Tuesday 18th of October at 12pm,
Seminar Room, Level 5, CWH. Over the last 12 months, we have had limited
attendance and agenda items despite varying times and venues. If you have any
thoughts on the meeting venue, time or content, please let me know.
We will be trialling sending the next edition of
the Childbirth Communiqué electronically with
hard copies available in ward and administration
areas. Please let us know if you need to update
your email address.
Happy reading!
Sam
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NZCOM MEETINGS
The NZCOM Meetings for Canterbury/West Coast region will be held on these dates
and times:
Wednesday 12 October
12.30pm Seminar Room, Level 5, CWH
Tuesday 01 November 7.00pm MMPO House, 374 Manchester St, Christchurch
Tuesday 06 December 7.00pm MMPO House, 374 Manchester St, Christchurch
Sponsored by
Canterbury Health Laboratories
BIRTHING SUITE NEWS
Firstly, I should like to thank all of you who have been so supportive of me in my new
role. I took up the post of Charge Midwife Manager for Birthing Suite at Christchurch
Women’s on September 1st, taking over from Anne Atkins who has now moved
to Burwood to work with Pam Truscott. Anne is now
working part time and spending more time with her
family, notably her granddaughter Billie, who we all met
at her afternoon tea and is rather gorgeous!
Anne
and Billie
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Birthing Suite has seen lots of changes of faces over
the last few months with rotation from the Maternity
Ward and Birthing Suite well under way and plenty of
new members of staff joining us. We warmly welcome
Carolyn Harris, Shamila Shah and Amber Morrill to
our team of ward clerks and Sue Stockwell, Robyn
Bryant, Lesa Freeman, Mars Burton, Pene Calder to
our team of core midwives. Megan Scott has also
joined us as part of her new grad programme.
Congratulations to Di Leishman and Rhonda Ayles
in their new roles. Di has taken up her new position as Local PMMRC Coordinator
and also will be busy with her other role as research midwife for Otago University.
Rhonda has been seconded as a champ for quality improvements but will still retain
some hours as a CCO on birthing suite. Happily, we will all still be seeing them both
around the hospital and Birthing Suite.
Sadly, we say goodbye to Fiona Garrett, Jess Overton and Kirsty Ewart and wish
them all the best for the future. This leaves some gaps in our establishment and
Chris Mazey and I have been interviewing midwives over the last few weeks.
Finally, congratulations to Anna Foaese and Fiona Garrett who have been awarded
leadership level in the QLP programme.
There are some areas in which we can work together to improve care to the women:• There have had some issues with ID bracelets. Every woman should have
an ID bracelet on arrival to Birthing Suite and we now admit all women even
in the assessment area.
• If you are handing over for epidural care, please communicate with the CCO
first and ensure the midwife that you are handing over to has an epidural
certificate.
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Canterbury Health Laboratories
• If the registrar is not available for a consult immediately, please do not just
leave a message for them as this is not a consult. The CCO’s should be the
next point of communication as they have a helicopter view of all events on
the birthing suite and will be able to advise and assist.
• We have just ordered more costly instruments for suturing. Please take care of
them, as to be frank, I would like to spend the money on other improvements
to Birthing Suite - such as more comfortable chairs for families in the birthing
rooms.
• Use the triple bell. If anyone in the room is paging 777 and the CCO is not
present, she needs to coordinate to ensure best care for every women and
baby.
• Spring is in the air and we will be transferring women to the primary units
overnight.
• The catheter policy for epidurals has been reviewed and we can now transfer
women out to the primary units post partum with catheters in situ.
• Many of you will have noticed I’ve been knocking on your doors in the
mornings to see if your women will be able to transfer to the primary units.
At the CDHB, we have all been working hard to improve communication and
therefore, the flow of women out to the primary units to use our valuable
resources and provide optimum levels of care for all women and babies.
• We now have only Xylocaine 1% in the rooms for cannulation and suturing.
• The K2 CTG package is available for all LMC’s and it’s free to all midwives
and doctors, so just contact our educators Tina and Lynne and they will give
you an access code.
Please feel free to come to talk with me about any concerns or suggestions for
improvements that you might have about Birthing Suite. I value all input and see us
all as a team working together to provide best care.
Natalie King
Charge Midwife Manager
Birthing Suite
Sponsored by
Canterbury Health Laboratories
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NEWS FROM RANGIORA HOSPITAL
Spring has arrived as we look out and see the daffodils in the hospital paddock. The
Friends of Rangiora Hospital have been busy over the past few months clearing the
vegetation from the road frontage fence to establish a new garden incorporating
the two old walnut trees. This is starting to take shape and you will notice a big
improvement when approaching the hospital gate.
We have now settled into our busier mode with more women birthing and transferring
postnatally, which is very positive for this unit. Thank you to all the LMCs who
continue to support this unit and those who have recently used this facility for the
first time. If you are unable to do a postnatal visit, the core staff are happy to do this
for you if you discuss this with them.
Pregnancy & Parenting Classes continue to be very popular, so please encourage
your women to book in early – phone 03 311 8650.
Midwives Meetings for LMCs, Core & Community Midwives are on
Monday, 10 October & Monday, 5 December 2011 at 1400hrs in
the staffroom – all welcome.
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Please contact me if you have any issues or queries that
you wish to discuss.
Suzanne Salton
Charge Midwife Manager
Rangiora Hospital
Sponsored by
Canterbury Health Laboratories
BURWOOD BIRTHING UNIT – THE PLACE OF “BEAUTIFUL BABIES”
Spring is here and with the blooming of the daffodils and blossoms, everyone’s
mood is on the rise despite the ongoing shakes. It’s been a particularly tough year
for Cantabrians and we wish to acknowledge all staff, LMC’s and families who have
lost their homes in the red zones. With spring comes new hope and we at Burwood
wish each and every one of you a better year ahead – maybe even a World Cup
win!!! Here at Burwood Birthing Unit, we are going “All Black” to support our team!
Increased Bed Numbers
The face of Burwood has changed in an effort to meet the needs of the women
of Canterbury following the quakes. As many of you will already know, we have
increased the beds from 7 up to 12 and in line with this, increased staff to two
midwives per shift. It was anticipated these beds would be fully occupied most
of the time but despite our best efforts, this has not happened. Therefore, we are
appealing to you to encourage your women to birth here or at the very least come
to Burwood for post natal care.
Two Family Rooms
We have also refurbished the theatre as a second family room to accommodate
more births at Burwood and again, we are appealing to you to support this change.
Welcome New Staff
Obviously to accommodate the above, we have increased the staffing – some will be
familiar to you as they have come to us from CWH - namely Loren Creedon, Susan
Cunningham, Diana Bates and Anne Atkins. Coral Moir and Lisa Preston return from
their sojourn in sunny Kaikoura. We also welcome a number of new casuals, Aroha
Abrahams and Lucy Griffiths. So our little team has grown and all are committed
to providing the women, babies and their families with an exceptional experience
We welcome women to have a look around, so encourage your clients to call and
make a time to view the facility.
Open Day
Burwood staff are planning an open day to raise our profile in the community, so
watch for dates and times.
Pam Truscott & Anne Atkins
Charge Midwife Managers
Burwood Birthing Unit
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Canterbury Health Laboratories
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NEWS FROM LINCOLN
Spring is here and isn’t it lovely to see the blossom appearing and the daffodils out?
Thanks to Nic Purcell of Ergostyle, who has made and given us a marvellous Oamaru
stone sculpture which has been placed in front of the hospital. It is a cubist-style
design of a reclining pregnant woman. Thanks also to Birches Manor in Prebbleton,
who have donated some buxus plants to go around the base and Craig Dickinson, our
gardener, who is donating some Portuguese Laurel to be planted as a background. The new Community Dental Clinic, in the hospital grounds, is finished and will have
its first patients coming through from Monday 26th September.
We’ve managed to get through the snow(s) - thanks to all the staff that made special
arrangements to ensure that they could get to work. Your efforts over the last year
have been amazing and are very much appreciated.
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The numbers of births and transfers have certainly increased since February and
we are welcoming LMC’s that have not used Lincoln’s facilities previously. Please
feel free to make a time to come and look around and talk to staff about how we
can support you. We love to show families around but ask your women to phone
the hospital (325 2802), prior to coming for a tour, to arrange a mutually-convenient
time with the staff member on duty. It is difficult to do justice to a tour when we are
very busy or have the Birthing Room(s) in use.
The Selwyn Breastfeeding Support group is held at the hospital on the first
Wednesday in the month from 10am and in the Lincoln Plunket rooms at same time
on every other Wednesday.
We now have four Medela breast pumps; three of which are available for a week’s
hire at $20.00.
Our feedback forms are being regularly filled out and the majority of feedback is
excellent. We encourage all feedback – positive and negative as we strive to improve
our service for all our users. Some feedback has been about our plumbing and low
water pressure, so you’ll be pleased to know work is underway to fix it – we should
notice a great improvement!
We have been experiencing some problems with people getting lost en route to
Lincoln hospital! There are maps on Birthing Suite and the Maternity Ward to give
out to the drivers. Apparently some GPS systems are directing people to a James
Street in Yaldhurst, so it would be good to communicate this to your women prior to
transfer. This has happened to an LMC who put Lincoln Hospital as her destination
– very annoying!
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Canterbury Health Laboratories
For those who don’t know, our meals are provided by Lincoln Hospitality, part of
the University, and we order them before 10am and 4pm daily. It is very helpful and
avoids wastage, if you can let us know in a timely fashion, of meal requirements for
women who are transferring. We are able to provide light meals outside of usual meal
times and partners are able to purchase lunch and/or dinner at $10.00 each. Just
a reminder to your clients that we are unable to offer overnight stays to partners/
support people.
As part of discharge planning, we are requesting that women plan their transport
home before 11am on their day of discharge. Obviously, we can have some flexibility
in certain cases but it does help us in planning for the families transferring to our care. We are running some education sessions and there will be limited places for LMC’s
– let us know ASAP to book a place.
October 27th Newborn Resus – 2 hours. Time to be advised
October 28th Breastfeeding refresher – 2 hours plus pre-reading for
Midwives (afternoon) and Ancillary staff(morning)
November
Adult CPR. Date and time still to be confirmed
Please call or email me with any queries.
Amanda Daniell
Charge Midwife Manager
Lincoln Hospital
ph 364 0239 (80239)
[email protected]
Sponsored by
Canterbury Health Laboratories
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IMPROVING THE CONTINUITY OF CARE
FOR PREGNANT WOMEN WITH HIGH NEEDS
This project enables LMCs to refer women to their general practice for a medical,
mental health or unhealthy lifestyle that can be exacerbated by pregnancy, but not
considered an obstetric risk. LMCs can attend the GP consultation with the woman
to enable a three-way conversation and develop a plan for the rest of the pregnancy;
they can claim for attendance at this consultation.
When referring women, please give them the Referral Form to give the GP, or
post/deliver to the GP if you think that this is more appropriate. To support better
communications, please write on the form the best way for the general practitioner
to communicate with you. For example: ‘Please print your consultation notes and
insert into the hand held maternity notes’ or ‘Please phone me to discuss’.
Please forward the MMPO copy as soon as possible after the referral has been
made to enable us to collect accurate up to date data for reporting to the Ministry.
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This project is now in its 15th month and is due to finish at the end of the year. We
are awaiting the MOH response to the evaluation report and whether we will be
able to continue offering free general practice consultations. The project aligns well
with the new Section 88 referral guidelines, so we may be able to integrate the two.
Any questions or feedback about the project, please contact Alison Young, Project
Manager at Planning and Funding, Canterbury DHB. (Phone 03 364 4163)
Sponsored by
Canterbury Health Laboratories
NEWS FROM LACTATION CONSULTANTS
As I look out the window with a wide expansive view, it is great to see all the blossom
and daffodils blooming in the park. Here’s to a long, uneventful summer.
We will be running Antenatal Breastfeeding Classes and Study Days for staff again
next year. The info for these will be sent out in the next communiqué.
We would like to note that the Study Day costs for LMC’s or non-DHB are $100.00
per 8 hour day (subject to review). If you are booked on a study day and fail to show
up or fail to let us know that you are not coming, the full fee will apply (as per CWH
Accounts Dept).
We have many people on the waiting list who miss out on the opportunity to attend
if we haven’t had notification of cancellations; we are then teaching less than
capacity classes.
We are gearing up for the next BFHI assessment in April /May of next year. The
Breastfeeding Policy is out for consultation and we would value comments from
you. If you have connections with the various ethnic groups, it would be valuable to
us to have some comment from them, if possible. If you have not received a copy
yet, or would like one, please email us.
Submissions are due back on the 30th September.
All correspondence to be sent to one of the following:
[email protected]
[email protected]
[email protected]
[email protected]
Cara, Dianne & Ruth
Lactations Consultants
Sponsored by
Canterbury Health Laboratories
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MIDWIFERY EDUCATORS UPDATE
September is with us and what a year it’s been! One year on from the first earthquake
event when many of us were separated from our families as we were in Rotorua for
the NZCOM conference – the city you would more expect to have some rock and
rolling; not our lovely garden city. But we are moving on and midwives have been
engaging in education throughout all the turmoil.
Here is an outline of some of our recent education activities and also an outline of
what’s to come for the rest of 2011 and into 2012.
PROMPT Workshop
This interdisciplinary workshop is run three times a year and is a proven favourite
with midwives and doctors alike. This year, staff from the Emergency Department
at Christchurch Hospital have joined us as very active participants, and feedback
from them has been overwhelmingly positive. Dates are still being organised for next
year, but please look out for our posters.
K2 Fetal Monitoring Online Learning Package
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We are once again very keen to promote this package throughout the region. This
is an important opportunity for midwives and doctors in Christchurch to significantly
improve their fetal monitoring knowledge and CTG interpretation skills. There is a
very strong recommendation from management, national and international agencies
for all staff to undertake this training at least once per year. This excellent resource
is available to all LMC’s and core staff free of charge. We encourage you to talk
with Lynne or Tina to obtain a Login ID, or if you are having difficulty accessing the
K2 system at work or at home.
The package allows midwives to complete their CTG training at their own pace
and gain points towards the elective education component of the Recertification
Programme.
‘Care of the Acutely Unwell Woman’ Course
One of our Birthing Suite core midwives (Louise McKinney) has been very proactive
in setting up this course and we have just completed two separate days. Both
Birthing Suite and Maternity core midwifery staff attended, as well as several LMC
midwives. The feedback has been very favourable.
We are very aware that maternity care is changing and we are more frequently
encountering women with complex medical and midwifery needs. We have also
observed increasing numbers of admissions to the Acute Observation Unit in Birthing
Suite. It is important that we recognise early, the potential and acute deterioration
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Canterbury Health Laboratories
in the woman’s condition and that we initiate an appropriate response. Throughout
the workshop, it was emphasized that the acutely unwell woman deserves great
midwifery care. Some of the topics covered were: Caring for women in respiratory
distress, Understanding heart rhythms and ECG’s,Testing reflexes and clonus, and
management of Central Venous Access Devices.
Journal Club
A reminder to you all that you are very welcome at Journal Club, which meets on
the last Tuesday of every month, 1.30 - 2.30pm in the Seminar Room, Level 5. We
have discussed some varied and interesting articles already this year and enjoy
meeting many of you at these informal sessions. Last month, we welcomed our
West Coast colleagues via our new videoconferencing link. If you have read an
article/journal recently that you think might be a good one to discuss, please let us
know. We also would love to invite other practitioners to facilitate a session, we’ll
support you in any way we can.
Management of Cord Prolapse
We are in the process of arranging education for a change in practice in managing
cord prolapse. We will be providing education sessions and ensuring each area
has an official cord prolapse box to enable midwifery and medical staff to carry out
this new procedure.
Background
A delay in management of cord prolapse (where a loop of umbilical cord is below
the presenting part and the membranes are ruptured) is associated with significant
perinatal morbidity and mortality. It is acknowledged as a serious obstetric emergency
and management of this obstetric emergency has been largely unchanged since the
1950’s. Traditionally management has incorporated:
• Calling for help
• All fours position with buttocks raised
• Continuous pressure on presenting part by vaginal examination
• Transport to OT
• Birthing the baby as quickly as possible
If the decision-to-delivery interval is likely to be prolonged, several studies have
shown no perinatal mortality with the technique of relieving the cord compression
and elevation of the presenting part by bladder filling. This procedure may also result
in diminished uterine activity, further improving blood flow via the cord.
Emergency delivery can proceed less rapidly, giving time for safer regional
anaesthesia as opposed to general anaesthesia. This also gives time for the midwife,
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Canterbury Health Laboratories
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obstetric and anaesthetic staff to explain the situation and required management
to the woman.
The bladder filling management is now being extensively used in areas within the
United Kingdom and also in other areas of New Zealand. Staff, who are familiar with
this technique, have been very positive regarding its benefits and also its positive
outcomes. This procedure has been looked at by the hospital Governance Committee
and agreed that this should be implemented within CDHB.
We will keep you informed of dates and times of education roll-outs. Please make
contact if you would like further information.
Watch this space…
For any information on midwifery education run by CDHB, please contact us by
telephone on our direct line on (03) 364 4730 (or CWH internal extension 85730/
pager 5061) or by email on [email protected] or [email protected]. If
you are at Christchurch Women’s Hospital, feel free to pop into our office on Level 5.
You will be aware that many of our workshops fill up very quickly. If you are missing
out, please contact one of us so that we can add you to our ‘workshop info’ list and
all forthcoming dates will be sent out to you electronically.
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Tina Hewitt and Lynne King
Midwifery Educators
Sponsored by
Canterbury Health Laboratories
ANTENATAL HIV SCREENING PROGRAMME UPDATE
Canterbury has had a 67% uptake of the antenatal HIV screening test in the first six
months of 2011. This is consistent with the last six months of 2010.
What of the other 33% of women?
Are all women being offered and recommended an HIV screening test?
Who is doing the test?
58% GP’s
28% Midwives
4% Obstetricians
10% Other
It is important that all women receive the information on why a screening test is
recommended and remember, it’s never too late to do an antenatal HIV test in
pregnancy. If a woman has not been offered and recommended a test with her first
antenatal bloods, you can:
Ask the lab to do the test using the original antenatal bloods providing it is within
3 months.
Do the test individually or alongside the subsequent antenatal blood test.
If you need help, information or resources, please contact Janette Philp, Antenatal
HIV Screening Coordinator by email at [email protected]
NB: Please contact Janette if you have a woman who returns either a reactive EIA
blood test or a positive HIV test. All information is confidential.
Sponsored by
Canterbury Health Laboratories
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UNIVERSAL NEWBORN HEARING SCREENING
AND EARLY INTERVENTION PROGRAMME
LMC’s are the vital link to providing parents with information about Newborn
Hearing Screening
To contact the Screening office, telephone 03-3644262
How can LMC’s help to detect early hearing loss in babies?
INFORMATION:
• Provide information to parents about the newborn hearing screening
programme during pregnancy.
• Let all mothers know that they will be offered hearing screening for their baby
soon after birth, especially parents whose other babies have not been part
of a hearing screening programme before.
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• Let parents know that newborn hearing screening is more accurate than
assessing hearing milestones alone.
DOCUMENT:
• For every baby, complete page 92 of the Well Child book – risk factors for
hearing loss.
• Home births – send the info on the NIR form, including the parents’ contact
details.
FOLLOW UP:
• Follow up by contacting the screening service if the baby hasn’t been
screened by one moth of age.
• Inform the screening service on the above phone number by two weeks
where a baby is born at home whether the mother wants her baby screened
or not (if not sending this info via the NIR form).
UPDATES FROM THE CDHB:
From the commencement of the CDHB’s screening programme to June 2011, there
have been:
11,075 completed screens.
11,364 women have been offered hearing screening -1.7% declined
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Canterbury Health Laboratories
95-97% of babies in our DHB are screened, including those known home births.
2.4% of babies who were screened and did not pass were referred to audiology.
4% of babies who passed screening but had risk factors have been referred to
audiology to have a hearing assessment by the time they are two years of age.
NSU TARGETS:
• Screen by one month of age: Approximately 95% of babies have been
screened by one month of age.
• Diagnose by three months of age: 7 of the 14 currently-diagnosed babies
with a hearing loss were diagnosed within this time frame. Three were within
20 weeks and one by 36 weeks. The others were from other DHBs.
• Provide intervention by 6 months of age: 13 of the 14 babies were referred
to intervention services by the time they were six months of age and one just
after at 6½ months.
• Two babies have been referred to the Southern Cochlear Implant Programme.
NB: If there are any child protection issues with a baby, please let the screening
service know who to contact and who is the legal guardian.
Angela Deken
CDHB Universal Newborn Hearing Screening and
Early Intervention Programme Co-ordinator
Christchurch Women’s Hospital
Private Bag 4711
Christchurch
Mobile: 027 591 3571
Phone: 3644 699 ext 85262
Sponsored by
Canterbury Health Laboratories
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NEONATAL TRANSPORT UPDATE
The Christchurch Women’s Hospital Neonatal Transport Team consists of up to
10 Neonatal nurses, 4 CNS – Advanced Neonatal Practice nurses and 6 rotating
Registrars.
The Neonatal Service has a retrieval transport service but not a “flying squad” – this
is the case nationally. The difference between the two is a retrieval team takes 2030 minutes to assemble a team and wait for an ambulance to pick up the team. A
flying squad would be ready to leave in minutes, with an ambulance stationed at the
hospital. St John Ambulance Service is the “flying squad” that primary birthing units
and home birth midwives can call. In most situations, you call the Neonatal ACNM/
co-ordinator first via the operator or the hot line in the primary units. Depending
on the baby’s initial response to resuscitation and the need for ongoing respiratory
support, you will be advised to call an ambulance.
There has been a steady rate of 80-90 retrievals a year and 40-50 back transports
(taking babies back to their home city). About half are by road ambulance and half
by plane with only a handful by helicopter.
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This year to date, we have collected 10 babies from Ashburton, 10 from Timaru, 7
from Greymouth, 7 from Lincoln, 4 from Burwood and 1 from Rangiora and despite
the earthquake, the numbers are similar to previous years.
We received significant support from other New Zealand Neonatal Units around the
February 22nd earthquake with 16 babies being transferred to other centres in the
week after the earthquake due to lack of staff, facilities and infrastructure.
Our current equipment is 15 years old. Currently, there are only 2 St John ambulances
that will accommodate this equipment safely. This has caused a number of issues and
delays in retrievals. We have been planning an upgrade of our transport equipment
since 2008. The new equipment is being supplied by Airbourne, a company in Texas,
who supply most of the neonatal transport equipment to the USA. We have a set-up
that is being used in the hospital at the moment for staff to become oriented with
how it works.
The new equipment has many benefits including humidified oxygen and a better
ventilator. We have the ability to have different configurations of the equipment as a
compact set-up for “in- hospital” use and an “out-of-hospital” set-up that will be on
a stretcher and will be able to fit into all St John ambulances safely. This will mean
delays due to equipment unable to be secured properly will be a thing of the past.
Adrienne Lynn
Neonatal Paediatrician
Sponsored by
Canterbury Health Laboratories
NEONATAL BCG VACCINATION
This article is to raise awareness of the MOH 2011 changes to the eligibility criteria
for Neonatal BCG vaccination, and how you and your clients can access this service.
Tuberculosis is still a real health threat in New Zealand with 270 people
diagnosed with TB in 2007.
High rates of TB exist among population groups from Asia, Africa and the Pacific,
particularly in recent migrants (less than 5 years).
Infants and young children are more likely to progress to severe generalised infection
if exposed to TB, including miliary and meningeal. Children from Asia, Africa and
the Pacific are disproportionately affected.
Extrapulmonary TB (particularly miliary and meningeal) is vaccine-preventable in
children. Children under 5 years considered to be at risk are eligible for free BCG
vaccination.
ELIGIBILITY CRITERIA:
• will be living in a house or family/whanau with a person with either current
TB or a past history of TB
• had one or both parents or household members or carers who have within
the last 5 years for a period of 6 months or longer in a country with a TB rate
of ≥ 40 per 100,000 (see the table in link below)
• during their first 5 years will be living for 3 months or longer in a country with
a TB rate of ≥ 40 per 100,000, and are likely to be exposed to those with TB
(see the table in link below)
http://www.moh.govt.nz/moh.nsf/indexmh/immunisation-diseasesandvaccinestuberculosis
Vaccination is recommended prior to 6 months of age.
Children who missed vaccination prior to 6 months may still be vaccinated at any
time up to 5 years. However, pre-vaccination Mantoux test is required.
Appointments can be made by contacting the BCG Administrator on 383 9498.
For queries or information about vaccination or eligibility, please contact:
Frances Ryan, BCG Coordinator on 383 6877 ext 99611
Frances Ryan
BCG Coordinator
Public Health Nursing Service
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19
INTRA-UTERINE FETAL PROGRAMMING:
INCREASING THE RISKS OF OBESITY AND TYPE 2 DIABETES
IN THE NEXT GENERATION
Did you know that the intra-uterine environment has profound effects on the
health of our offspring?
Over-nutrition of the fetus can result in permanent changes in the programming of
the neuro-endocrine system. This programming is largely via epigenetic processes,
the way in which certain genes are switched on and off, e.g. by methylation. An
excessive or abnormal nutrient load from the mother (such as when the mother is
obese, gains excess weight in pregnancy, or has poorly controlled diabetes) can
lead to abnormal fetal programming that increases the risk of developing obesity,
insulin resistance, type 2 diabetes, and cardiovascular disease in later life. This is
sobering news during the current pandemic of obesity and type 2 diabetes. Possibly
the most important public health message this decade is to ensure the health of
pregnant women to prevent disease in the next generation.
20
Midwives, Obstetricians, and GPs need to consider the long term outcomes for
mother and baby as well as pregnancy outcomes.
• All pregnant women should have a Body Mass Index assessment (BMI)
so that recommendations about appropriate weight gain in pregnancy
can be made. The benefits of a healthy diet should be discussed, and a
referral made to a dietitian, if appropriate.
• Universal screening for gestational diabetes with a 50g Polycose test is
recommended between 24-28 weeks gestation. However, women at risk for
Type 2 diabetes and pre-diabetes (impaired glucose tolerance and/or impaired
fasting glucose) should be offered screening in the 1st trimester with a full 2
hour 75g glucose tolerance test (GTT) and if normal, this should be repeated
between 24-28 weeks gestation.
• Please do not delay the Polycose test until the 28th week. The Polycose
test, confirmatory GTT, and clinic referral should be completed by 28 weeks,
wherever possible. This is because the fetal growth rate is highest between
26 and 33 weeks gestation and a late diagnosis of gestational diabetes
often results in the development of fetal macrosomia before monitoring and
treatment have been initiated.
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Who is at risk of type 2 diabetes?
Women with the following characteristics are at risk of Type 2 diabetes and should
be screened with a 75g glucose tolerance test in the 1st or early 2nd trimester, in
addition to screening for gestational diabetes at 24 – 28 weeks gestation:
1. Previous gestational diabetes, impaired fasting glucose, or impaired glucose
tolerance
2. Polycystic ovarian syndrome
3. Previous macrosomic baby or unexplained stillbirth
4. 1st degree relative with diabetes
5. Women who have two or more of the following risk factors: high risk ethnicity
(Maori, Polynesian, Asian, South American or African); age ≥30; elevated BMI
(see below)
6. Pregnant women with a HbA1c ≥5.6%, or a random glucose ≥5.5mmol/L at
booking (under investigation STEP)
What is a normal BMI?
BMI is a mathematical measurement [weight (kg) / height2 (m2)] that compares a
person’s weight and height and it is a useful marker of obesity. As BMI doesn’t take
into account frame size and muscularity, there are different ideal BMI ranges for
different ethnicities.
Normal BMI: Caucasian <25
Asian <23
Maori & Polynesian <27
What are the weight gain guidelines for pregnancy?
The traditional weight gain guidelines in pregnancy are overgenerous. A number
of studies have shown that it is safe for obese women (BMI>30) to put on as little
as 6kg, and for morbidly obese women (BMI >40) not to put on any weight at all in
pregnancy. Tighter weight gain recommendations may decrease the risk of adverse
pregnancy outcomes for obese women such as hypertension, pre-eclampsia, and
diabetes.
Please don’t underestimate the potential harm to the next generation from excessive
weight gain or missing a diagnosis of diabetes in pregnancy.
If you have any questions, please contact our antenatal clinic Diabetes Educators
by telephone on 03 3644 420 or email:
Dr Ruth Hughes: [email protected]
Dr Peter Moore: [email protected]
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21
SAFETY & QUALITY UNIT
DOCUMENTS
The Women’s and Children’s Breastfeeding Policy has been amended with the section
on Artificial Feeding being removed and made into a stand-alone policy – Breast
Milk Substitute, Ref 6906. These policies are available on the intranet.
The Neonatal Handbook has also been updated and is available via the intranet.
CTG INTERPRETATION
22
Over the past few weeks, we have
been seeing more cases where
deterioration of the fetal heart
rate pattern on CTG has not been
recognised initially. We will be
encouraging staff within CWH to
refresh their knowledge of CTG’s by
completing the K2 Fetal Monitoring
Training Package at least once a year. This package is accessed via the internet
and is also available to you as an LMC. Please contact the Midwifery Educators
Tina Hewitt or Lynne King on 3644 730 to obtain a log-in and password, if you do
not already have one.
The CDHB Electronic Fetal Monitoring Guideline, which is available via the CDHB
website, also provides further useful information on CTG interpretation.
STAFF CHANGES
Gail Prileszky, who made a significant contribution to the work of the Safety and
Quality Unit Team, has resigned from her post as Quality Coordinator Maternity.
This position is currently out to advert with the expectation of appointing a new
post holder in the near future.
Cathy Rewiri, Quality Co-ordinator Gynaecology, started with us last month. She
is available to assist all staff in their respective clinical areas with
quality activities including clinical audit, improvement projects,
incident review and analysis, reviewing patient information and
clinical record documents, developing quality programmes,
patient surveys, clinical guidelines and ensuring all activities meet
accreditation and certification standards.
As required, Cathy will also be involved in Root Cause Analysis (RCA) teams
investigating significant events. Her clinical background gives her insight into issues
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in the clinical areas, and is happy to offer advice and support to staff in relation to
any quality activities.
Cathy may be contacted by phoning extension 85780 or email cathy.rewiri@cdhb.
health.nz
Lisa McKechie
Team Leader
FIVE MOMENTS – IT’S COMING, GET READY!
The ‘5 moments’ of hand hygiene has been
promoted by the World Health Organisation and
Ministry of Health as a way of ensuring compliance
among healthcare workers with hand hygiene.
It relies heavily on the access to alcohol-based
hand rub at the bedside and takes less time (and
is more efficient in terms of effects on the skin)
than hand washing.
The Clinical Board has supported the roll out of this approach throughout the
CDHB, so you will see posters like the one shown at every bedside as well as lots
of alcohol hand rub dispensers.
Within Christchurch Women’s, we will have a combination of the wall-mounted
alcohol dispensers as well as those at the end of beds.
There is a very clear expectation that whoever comes into our hospitals to deliver
care will comply with these 5 moments. The Safety and Health Commission has
indicated that they want a compliance of 90% in DHBs from June 2012. In order to
achieve, this we have a lot of work to do!
Although auditing will not be part of the initial roll out, it will be introduced at some
point. Staff will be observed for either washing or use of alcohol hand rub at the
following times:
• Before patient contact
• Before a procedure
• After procedure of body fluid exposure risk
• After patient contact
• After contact with patient surroundings.
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23
These moments exist regardless of whether gloves are worn – indeed, gloves can
have tiny holes in them which makes hand hygiene even more important when they
are removed.
Women in this division will have access to information and posters which set down
the expectations of hand hygiene among their carers. They will also be encouraged
to ask their healthcare worker to clean their hands before they touch them. Hence,
if you want to avoid embarrassing moments, make sure you clean your hands in
accordance with 5 moments. If you would expect YOUR healthcare worker to have
cleans hands before touching you – make sure you do this for those in your care.
Anything less is not acceptable.
Jane Barnett
Clinical Nurse Specialist – Infection Prevention and Control
Christchurch Women’s Hospital and Primary Units
24
A CLINICAL AUDIT OF RhD IMMUNOGLOBULIN IN NEW ZEALAND
A retrospective two-part audit was undertaken by six NZBS Transfusion Nurse
Specialists and two DHB Clinical Nurse Specialists at eight District Health Boards
(DHBs). This audit was conducted in two parts; firstly, looking at RhD negative women
giving birth and secondly, at requests for RhD Immunoglobulin received, ensuring
the clinical events in the two audits did not overlap. Data was obtained from NZBS,
DHB and community laboratories, clinical notes and Lead Maternity Carers.
In the first part of the audit, 460 RhD negative women giving birth within public
hospitals and birthing centres at eight DHBs, where the mother was known to be
RhD negative were assessed. The 96% of RhD negative women, who gave birth to
RhD positive babies, received RhD Immunoglobulin and 98% of those received it
within 72 hours of birth.
In the second part of the audit, 640 RhD Immunoglobulin requests were audited
(80 per DHB). The majority of requests were for births and third trimester obstetric
indications. Although no formal Ministry of Health (MOH) policy exists for Routine
Antenatal Anti-D Prophylaxis, 5% of requests were for this indication. Only 3 of
the 46 requests (7%) relating to events occurring in the first trimester received the
recommended 250IU dose of RhD Immunoglobulin. The remaining cases received
625IU.
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In both parts of the audit, it was noted that four of the eight DHBs seldom performed
Kleihauer tests. The difference between the DHBs who did or did not perform
Kleihauer tests (87% vs 2%) was highly statistically significant. This marked
difference correlated with the absence of, or knowledge of, a policy on Kleihauer
testing within the DHB.
Administration was documented in 99% of available records and consent in 93%.
The documentation of administration and consent for RhD Immunoglobulin could
not be established in 6% of doses because the respective records either could not
be found or were not provided by the LMC.
Recommendations:
• That clinical staff are reminded of the significance of post-exposure anti-D
prophylaxis, both at birth and antenatally.
• That communication between LMCs when handing over patients includes
whether RhD Immunoglobulin administration has occurred.
• That clinical staff need to be further educated on the availability and clinical
indications for the 250 IU RhD Immunoglobulin dose.
• That clinical staff are reminded of the importance of maintaining true and
accurate records of the prescribing, consenting and administration of RhD
immunoglobulin.
• That the importance of testing for fetomaternal haemorrhage is reiterated,
and that this is promulgated in DHB policies throughout New Zealand.
• That laboratories anticipating a large increase in Kleihauer testing give
consideration to other technologies such as gel agglutination micro columns
as a screening test.
The full report on this audit can be found on the CDHB Clinical Audit Register, 1586.
Angela Wright
Transfusion Nurse Specialist
New Zealand Blood Service
c/o Blood Bank, Lower Ground Floor, Parkside East, Christchurch Hospital.
phone 03 364 1620, internal 81620
mobile 021 577 532
email: [email protected]
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25
MIDWIFERY LIAISON ROLE FOR 5TH YEAR MEDICAL STUDENTS
Fifth year medical students rotate through Christchurch Women’s
Hospital as part of their five week Obstetrics and Gynaecology
attachment. During this time, they are rostered to Birthing Suite for 4-5 shifts including
a night shift. In their 6th year, (Trainee Intern) students are attached to a team.
Students are required over their 5th and 6th year to actively participate in providing
care for women during at least five labours and births.
• At least three of these must be normal births
• Participation must include care in the first stage of labour and supervised
conduct of normal births.
• Students must conduct at least two postnatal visits to mother and baby.
This is a time when students have exposure to the midwifery philosophy of women
– centered care where the woman is central to decision making and the focus is
normal birth. This is also an opportunity for students to gain insight into the role of
the midwife.
26
We get very positive feedback from students related to their time in Birthing Suite.
However as we are all aware, it is not always straightforward for the students’
learning needs to be met in a very busy and stressful clinical environment. The O&G
department is always seeking ways that can enhance student’s involvement and
also improve the experience that midwives have when working with them.
It will always be a women’s choice to have a student involved in their labour and
birth experience, but it may be possible to improve the communication around this
discussion.
In 2008, the university in discussion with Cath Borrett – the Charge Midwife at that
time – established a midwifery liaison role in a move to facilitate communication
between the Dept. of O&G and Birthing Suite. Barbra Pullar – Research Midwife –
has been in this role to
•
•
•
•
support students and all midwives working with them in Birthing Suite.
facilitate communication between students and staff
find innovative ways for students to be involved with women
educating women about the role of medical students
We would really like to hear from midwives with any ideas or suggestions.
Peter Sykes Head of Department of O&G
University of Otago, Christchurch
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Barbra Pullar
Research Midwife
3644 625
Canterbury Health Laboratories
PERINATAL AND MATERNAL MORTALITY REVIEW COMMITTEE
I have just been appointed the Canterbury PMMRC Regional Coordinator and will
be situated on Birthing Suite at Christchurch Women’s Hospital.
The Aims of the PMMRC:
• Identify areas in maternity and newborn care where improvements could be
made.
• Establish a data base to review all perinatal and maternal deaths nationally.
• Plan is to reduce perinatal and maternal deaths through audit and feedback.
The PMMRC is an independent committee that advises the Minster of Health on how
to reduce the number of deaths of babies and mothers in New Zealand.
Terms of Reference:
• Review deaths of all infants born after 20 weeks gestation or weighing 400gms
that are stillborn or die within 28 days of their birth.
• Review the death of a women while pregnant or within 42 days of the
termination of the pregnancy.
At CWH, we hold a monthly perinatal education meeting on the 4th Tuesday of
the month at 1230pm in the Seminar Room on Level 3, where each case has a
multidiscipline review. All LMC’s will be informed prior to the meeting if they have a
case being presented. A plan for future pregnancies is established at the meeting
and then the deaths are classified.
The PMMRC produces a yearly report and this can be obtained from its website.
http://www.pmmrc.health.govt.nz/
It recommends all women should commence maternity care before 10 weeks:
• Opportunity to offer screening for congenital abnormalities, sexually
transmitted infections, family violence, and maternal mental health.
• Education around nutrition, smoking, alcohol and drug use.
• Recognition of underlying medical conditions and appropriate referral
• Identification of vulnerable women at increased risk of perinatal mortality.
This year’s report highlights the following flags associated with poor perinatal
outcomes:
• Obesity
• Maternal mental health problems
• Socio-economic deprivation
• Maternal medical conditions.
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27
1) Maternal age (<20 and greater than 40 years)
The under 20s have a significantly higher rate of stillbirths and neonatal
deaths. Traditionally, this is one group of women that many LMC’s would
think of as being fit young low risk women but the data is certainly showing
us otherwise. This group of woman are frequently risk takers, smokers,
drug and alcohol use, with low socio-economic resources which can
affect living situations. Partners may also be teenagers with few resources.
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2) Multiple pregnancy
• Stillbirth rate 3 greater than that of singletons
• Neonatal death rate 7 greater
• Perinatal death rate 3.7 greater
• Five time rate of cerebral palsy
The Australasian Maternity Outcomes Surveillance System (AMOSS) is a national
surveillance mechanism designed to study a variety of rare or serious conditions of
pregnancy, childbirth and the postnatal period phase, through translating the findings
from these studies into reliable evidence based practice. The aim of AMOSS is to
improve the safety and quality of maternity care in Australia and NZ.
Current studies:
Amniotic Fluid Embolism
Antenatal Pulmonary Embolism
Placenta Accreta
Peripartum hysterectomy
Morbid obesity BMI < 50
Eclampsia
As local coordinator, I am responsible for data collection and reporting to AMOSS
monthly. A file is available on Birthing Suite.
If you have any questions, please feel free to contact me:
Dianne Leishman
PMMRC Co-ordinator
[email protected]
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PHYSIOTHERAPY UPDATE
Like everyone, we have had an interesting and shaky 12 months, and are now all
enjoying the excitement that the Rugby World Cup brings to our shores.
We recently celebrated World Physiotherapy Day with a fun quiz shared with our
colleagues throughout the hospital, and the prize of a morning tea was won by 2
core midwives on the 5th floor.
Rebecca Dodson has gone on maternity leave in August and Niamh Keats has taken
on her role as Team Leader.
We have had a high percentage of DNA’S (did not attend) post quake, so please
do make sure your clients realise that there is a high demand for our physiotherapy
service and if they cannot make their appointment to please phone and reschedule.
We are still having some issues with insufficient information on referrals coming
through. Informative referrals allow us to triage appropriately, so that we can see
your clients as efficiently as possible. Our obstetric outpatient service is for women
16/40 gestation through to 6 weeks postnatally. Please consider before referring a
woman close to term. There is usually at least a 1-2 week turn-around time before
an appointment can be attended.
We rarely get the opportunity to meet you all face-to-face so we thought we would
like to introduce and “re-introduce” the Physiotherapy Team at Christchurch Women’s
Hospital.
Niamh
Keats Maree Frost
Mary
Winchester
Jess Smithers
Jane
Dickson
Hilaire
O’Dea
Niamh works 3.5 days as Team Leader/sees outpatients and covers obstetric ward
on Wednesday mornings, teaches parent education classes and covers
the gynae ward on Mondays.
Maree works 2 days a week and specialises in pelvic floor dysfunction.
Mary works 2 days a week. Mary sees both gynae and obstetric outpatients,
teaches parent education classes and covers the obstetric ward.
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29
Jess works 4.5 days a week on the gynae ward and also sees obstetric
outpatients.
Jane works 1.5 days on the obstetric ward and sees obstetric outpatients.
Hilaire currently covers all physiotherapy services on a casual basis, and teaches
parent education classes.
If you have any questions regarding the above information or any other areas of our
service please feel free to contact the department. We welcome and appreciate any
suggestions or feedback on our service. Once again, thank you for you your referrals
and support, and have a safe and happy rest of 2011.
Niamh, Jess, Maree, Mary, Jane and Hilaire
Physiotherapy Department CWH
Ph: 3644908 Fax: 3644290
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SOCIAL WORK SERVICE AT CHCH WOMEN’S HOSPITAL
There have been some staff changes in our service in recent months. We welcome
our new Team Leader, Keryn Burroughs, who brings to the position several years
experience as a Maternity social worker at Women’s and will be known to many of
you. She has been Acting Team Leader since October 2010.
Keryn is 0.8 Team Leader and will continue to work for 0.2 in Maternity. She will
provide valuable support and supervision to our social work team and we welcome
her leadership.
Our team consists of 10 Social Workers who are passionate about Women’s
Health and are fully qualified at Tertiary level. We are all members of ANZASW - our
Professional Association and the Social Work Registration Board or are working
towards this. We appreciate the financial support from the CDHB for our membership
costs.
In Gynaecology including Lyndhurst, we have four part time staff: Sharron Eastwood
0.6 Page 5108, Sarah Kidd 0.65 Page 5109, Heather Noble –Young 0.65 Page
5494, Wendy McIntosh 0.7 Page 5493.
In Maternity: Sylvia Cramer 0.9 Page 5498, Fiona Lothian 0.65 Page 5116, Caroline
Oliver 0.4 Page 8745.
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In NICU: Nicci Weild 0.8 Page 5400, Fleur Harraway 0.7 Page 5110 and an up
coming vacancy of a 0.5 position as Gabrielle Evatt sadly leaves on 7 October 2011.
We provide a service to both in-patients and out-patients and welcome referrals
from LMC’s who have concerns about their client and her family. The earlier that we
receive a referral, the more we are able to offer in terms of support and planning especially where there are care and protection concerns for the unborn or newborn
baby or other family members.
We can provide support and information with relationship difficulties, advocacy,
decision making, stress management, anxiety, family violence, attachment and
bonding, still birth and infant loss as well as referral to Community Agencies and
other services such as for counselling or financial advice.
We are able to organise Professional Planning meetings, write Birth Plans and arrange
discharge planning meetings where appropriate.
We regularly liaise with CYF and the Police Family Safety Team, and put referrals
through to the CDHB Child and Family Safety Service (formerly SCAN), so that
concerns about a baby can be noted.
We work closely with Kathy Simmons, Christchurch Women’s Maori Health Worker
and appreciate the culturally-appropriate assistance that she provides to women
on the wards.
We value our relationships with our nursing, medical and other Allied Health
colleagues, and are happy to be contacted to discuss concerns and issues about
patients.
We can be also be contacted Monday to Friday, 8.00am – 4.30pm, through the
social work secretary on 3644-441. Ext 85441. Direct phone numbers available on
all ward levels.
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31
CANTERBURY HEALTH LABORATORIES WEB RESOURCES
The team at the lab have been working on the availability of test information online.
A new web address has been launched:
www.chl.co.nz
This page acts as a gateway to all areas the laboratory operates in.
Two areas may be of value to Lead Maternity Carers:
Test Manager
32
Test Manager is a site designed to house information about all of the testing CHL
conduct. You will find the following information for each individual test:
•
•
•
•
•
Specific contact details for the correct department & person
Price
How often we conduct the test
Standard turnaround time
Specimen collection requirements
Blood Test
Blood test is a site designed with the community in mind. It contains location maps
to CDHB Blood Collection centres, as well as useful information to give to patients
regarding tests.
There are handouts on how to prepare children for blood tests, and for pregnant
women on how to prepare for glucose load tests.
Community Blood Test Requests
Canterbury Health Laboratories are now conducting a vast majority of blood tests
for the Canterbury region, as all Medlab blood tests are processed in this lab. As
a result, you will need to know what blood tubes to use for which tests as some of
these may have changed.
Our websites also have information about tests as they change, and all the memos
associated with those changes.
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HOSPITAL PARKING UPDATE
HAGLEY PARK
With the cricket season starting, we no longer have access to the grassed area
immediately to the side of the cricket oval and the Council has reseeded the area
for the start of the season. A “parking hard surface” has been laid behind the
horticultural centre, but often full for parking by 0800hrs most mornings. Alternative
parking areas that could be considered are:
• Roadside parking along Brockworth Place (off Deans Ave)
• Botanical Gardens parking over Armagh Street Bridge (P180 is not being
monitored by the Council)
• Roadside parking along Walker and Wilmer Streets (Between Montreal and
Durham Streets)
• Around Mona Vale Park
There are a number of open air and under cover car parks along both St Asaph St
and Rolleston Avenue.
TENNIS COURTS, CRICKET OVAL & BOTANICAL GARDENS PARKING
Both the tennis courts and cricket oval parking area is available 24/7, as well as
the Botanical Gardens car park accessed from the Armagh St bridge. The Council
are not monitoring these P180 areas and they all provide hard surface parking. For
any staff and patients using the Botanical Gardens car park, there is a path running
through the gardens across a small bridge directly into the rear of the hospital.
COUNCIL CAR PARK BUILDING
The Council Car Park Building is now open.
For any further queries regarding parking, please contact Support Services on Ext
66870 or 68634.
Rachel Cadle
Support Services Manager
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33
MEMO FROM NZ BLOOD
34
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ELECTRONIC CORRESPONDENCE FROM
CHRISTCHURCH WOMEN’S HOSPITAL
For several years, many LMC’s have received electronic correspondence from
Christchurch Women’s Hospital as follow up to clinic referrals and specialist
appointments for women under your midwifery care. Email exchange of information
is common between health providers, and is increasingly so.
Could you please be reminded that email addresses that you provide must only
accessed by yourselves or the midwifery practice that you belong to, not an email
accessed by your family, for example.
If you need to update your email address, please contact Joy Aitken, PA to Service
Manager - Women’s Health, who manages the access agreement lists for CDHB
facilities.
If you do not wish to receive email correspondence, please contact Pam Law, Charge
Midwife Manager, Women’s Outpatients at your earliest convenience.
Many thanks for your assistance in this matter.
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35
FEEDBACK
Birthing Suite
“Great staff!”
Maternity Ward
“Your midwife service for us as a family and my wife was fantastic. We travelled
4.5 hrs to Christchurch and had our baby girl with great care and professionalism.
Thank you again.”
Burwood Birthing Unit
“A wonderful time, midwives and staff are excellent. I felt very supported and cared
for.”
“Wonderful experience staying and birthing here. Excellent, friendly staff, helpful
and insightful. What a great service to mums.”
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“Coming here was the best thing I could have done being a first time mum. Staff
were very helpful and gave me confidence. Thank you so much!”
“Thank you so much to all the staff at Burwood Birthing Unit for making our stay
so good! I couldn’t have hoped for better service and care. I will definitely be
recommending Burwood as a fantastic place to welcome a new baby to the world.
Thanks again.”
“All midwives are awesome, helpful, kind and very patient. A great stay and had
first baby. Thank you all at Burwood Birthing Unit for all of your help and advice.”
“Absolutely perfect - wouldn’t change a thing. Midwives are very helpful and polite,
food was nice. Thanks to everyone that helped out.”
“Absolutely amazing staff. Thank you so much for all the support and patience you
have all given us while being here.”
“Yay for the Burwood Birthing Unit - long may she reign!! Such a friendly and
welcoming atmosphere. Love the concept of own rooms but element of shared
facilities. We felt very welcomed and at home.”
“Thank you to the team at BBU! You have great staff who are all so positively friendly
and supportive. You obviously love what you do. Thanks.”
”Fantastic, friendly staff; 100% helpful at all hours. We could not ask for more as
new parents. Thank you to you all.”
“Thank you for all your advice and guidance, enjoyed our stay yet again.”
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Rangiora Hospital
“My wife is a regular at Rangiora Hospital and she has received this time as well as
previous births - the best level of care that anyone could ask for. We thank you so
much for all the staff for a wonderful birthing experience and we would recommend
this unit to anyone. Thanks again, kind regards.”
“This is one big compliment for Rangiora Hospital. I was thoroughly impressed with
everything that I experienced during my stay. All of the staff - midwives, student
midwives, orderlies, etc, were fantastic. Very caring, professional and attentive. I loved
the fact that meals were served in a communal dining room and in general, loved
the feeling of the hospital. Well done to all who were on duty and a big thank you.”
Lincoln Hospital
“Thank you for a restful stay. I feel very lucky to have spent my first few days with
new baby at Lincoln. Such a wonderful and helpful start.”
“Thank you for looking after me and my baby. I enjoy your friendliness and kindness
in here.”
“Thank you for all your care at the birth of our baby on 15 May 2011 and, for all your
care and support during his first few days of life. We were happy with the quality of
care that we received and for the yummy meals provided. Many thanks.”
“Thanks so much for looking after us during our stay. In the aftermath of the
earthquake, it was such a lovely place to give birth and spend a few nights getting
the hang of being a new mum.”
“We are delighted with the arrival of our beautiful son and would like to thank you all
for looking after me during my nine long months of pregnancy. We are very grateful
for all the help and support offered to me during this time. I don’t know what I would
have done without you all. Many thanks.”
“Great support from all midwives, they were all very approachable, very professional
team with an energetic personality. I would recommend this place to anyone.”
“Thank you very much. Wonderful care, very kind nurses, lovely room and facilities,
yummy meals, learnt lots - thanks.”
“Thank you for all you did for me and my family during and after the birth of our son.”
“Many thanks for your amazing care during our stay, every staff member was
dedicated and supportive, no matter how busy they were. Special thanks for the
help with breast feeding (at 2.00am) and the bassinette attached to the bed, which
gave baby and I some much needed sleep.”
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37
“Thank you ever so much for all the wonderful help and support you have shown my
wife and daughter. The care here has been fantastic. We would highly recommend
coming here to any expectant parents.”
“Very helpful and friendly staff, and lovely homelike feel about the place. We enjoyed
staying here.”
“Thank you for looking after us in May this year. We truly had a wonderful experience
at Lincoln and appreciated the care, knowledge and support that you showed us.
Our daughter is growing and thriving, and we feel most blessed to have her in our
lives. Again, thank you so much.”
“Supportive, kind and helpful staff. Spending two days at Lincoln after the birth of
our first child was wonderful. We were given all the support that we needed. But also
given space to spend time as a family and learn about our baby. The atmosphere
is really relaxed and welcoming. The facilities are clean. Lovely to have access to
kitchen, plus healthy food for moms and partners. This is an excellent service.”
“Thanks for helping us through this special moment in time.”
“Great staff, very pleasant and easy to attain information from. Would recommend
to anyone.”
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“To all the staff at Lincoln Maternity, Thank you so much for the wonderful care that
we received after the birth of our daughter. She was quite a screamer at first, thanks
for taking her off my hands for a few hours of much needed sleep. At 9 weeks, she
has settled down nicely. Her big brother is enjoying the addition to our family too.
Your support of breastfeeding was great and we sorted out the initial problems, so
now it’s all good!”
Sponsored by
Canterbury Health Laboratories
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Sponsored by
Canterbury Health Laboratories