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Community Midwife Equipment List Clinical Guideline
V2.0
July 2019
Community Midwife Equipment List Clinical Guideline V2.0 Page 2 of 17
1. Aim/Purpose of this Guideline 1.1. To provide community midwives with a list of equipment that they should carry individually and the availability of additional equipment. This should be carried in the standardised bag provided by the trust New 2018 1.2. This version supersedes any previous versions of this document.
1.3. Data Protection Act 2018 (General Data Protection Regulation – GDPR) Legislation The Trust has a duty under the DPA18 to ensure that there is a valid legal basis to process personal and sensitive data. The legal basis for processing must be identified and documented before the processing begins. In many cases we may need consent; this must be explicit, informed and documented. We can’t rely on Opt out, it must be Opt in.
DPA18 is applicable to all staff; this includes those working as contractors and providers of services.
For more information about your obligations under the DPA18 please see the ‘information use framework policy’, or contact the Information Governance Team rch-tr.infogov@nhs.net
2. The Guidance 2.1. Antenatal/Postnatal Bag contents
Neonatal electronic thermometer
C02 monitor
Intrapartum transfer forms
SBARD stickers
Sphygmomanometer
Stethoscope
Urine testing sticks (COMBU7)
2 x MRSA screening swabs
Pinard stethoscope/sonic aid and gel
Venepuncture equipment/forms
Cannulation equipment
IV administration set (also for cord prolapse management)
Swabs for microbiology
MSU pots/none MSU urine pots
Disposable towels
Disposable gloves - latex - non sterile/sterile
Disposable syringes, needles,
Disposable speculum
Glycerine suppositories/enemas
Newborn screening equipment
Cord clamp
Sharps bin
KY Jelly - sterile sachet
Laerdal masks - adult
Community Midwife Equipment List Clinical Guideline V2.0 Page 3 of 17
Disposable tape measure
Appropriate documentation
Cutan hand cleaner
Large BP Cuff (may be shared between team)
2.2. Birth Equipment
Delivery pack
Red linen bag and liner – (If appropriate)
Perineal repair pack -RCHT packs incl with Delivery
20ml syringes
Green needles
Suturing material (Vicryl 2.0)
Raytec swabs
Disposable airways 000, 00, 0
Disposable Ambubag (500 ml reservoir)
Cord clamps
Hat
Laryngoscope/tongue depressors
Adult non re breathe mask
Adult size guedel
Entonox equipment plus disposable mouthpiece
Bladder filling equipment - Foley’s catheter,
2x 500 mls iv infusion 0.9% Sodium Chloride (to be used iv or to fill the bladder) (New 2019)
IV giving set
Catheterisation Pack, In/out catheter
Instilligel
Amnihook
Cannulation equipment
Needles and syringes
Sanitary pads and swabs
Disposable Aprons
Clinical waste bags and ties
Sterile gloves
Non sterile glove
Amnihook
Goggles
Placenta box, Daniels placenta bag
Yellow clinical waste bags
Appropriate documentation i.e. proformas, Pause sticker
Entonox equipment plus disposable mouthpiece
Scales/alcohol wipes
Spare batteries for sonicaid and scales
2.3. Drugs
Syntocinon 5iu/ml x 2 (to be changed 2 monthly)
Ergometrine 500mcgs x 2 (to be changed 2 monthly)
Lidocaine 1%/10mls x 2
Vitamin K 1mg x 2 including oral syringes
Community Midwife Equipment List Clinical Guideline V2.0 Page 4 of 17
Adrenalin pack from pharmacy
1 Litre saline 0.9% (for IV fluids/bladder filling)(New 2019)
Misoprostol (See PGD in midwives shared folder) See appendix 3 for Audit form New 2018
2.4. Maintenance
It is each midwives responsibility to ensure that their bags are kept clean, tidy and fully stocked up and all drugs and equipment are in date.
The intrapartum ‘grab bag’ should be checked and restocked after each transfer and also on a weekly basis.
Six monthly checks of entonox equipment and scales.
Two yearly check of sphygmomanometer.
Sonicaid to be checked as and when necessary.
2.5. Intrapartum transfer equipment Grab bags: All birth centers should have a ‘grab bag’ which should be used for all intrapartum transfers to the acute unit, and should contain:
Delivery pack with cord clamp
Pack of swabs
Towels for the baby
Maternity pads
Nappy
Hat for the baby
Neonatal bag and mask
Guedal air way
Syntocinon 5iu/ml
Sonicaid
Syringes and needles
2.6. Community midwife homebirth bag standardised packing instructions (New 2018)
This is the front of the bag (front pocket has clear pouch).
Community Midwife Equipment List Clinical Guideline V2.0 Page 5 of 17
In the large zipped pocket to the front of your bag please place your neonatal equipment: mask, guedel airways (000,00 and 0) and any extras such as cord clamps, a hat and a laryngoscope with blades if you use one. You should also place your emergency adrenaline pack in here. New 2018
Left hand side pocket of the bag new 2018
In this pocket please place your suturing equipment. 20ml syringes, green needles, suturing material (vicryl 2.0) and lidocaine. New 2018
Community Midwife Equipment List Clinical Guideline V2.0 Page 6 of 17
Right hand pocket of the bag, In this pocket we have the adult resus equipment and Entonox mouthpiece. A non-re-breathe mask and adult size guedel airway. New 2018
Community Midwife Equipment List Clinical Guideline V2.0 Page 7 of 17
In this pocket we have bladder filling equipment including a foleys catheter and catheter bag which can be used for standard catheterisation. New 2018
Top pocket of the bag. New 2018 In here we have documentation and spare batteries New 2018
Community Midwife Equipment List Clinical Guideline V2.0 Page 8 of 17
Main body of the bag. New 2018
In the top, clear pocket there are needles, syringes, drugs and cannulation equipment. New 2018
Community Midwife Equipment List Clinical Guideline V2.0 Page 9 of 17
In the main part of the bag: at the top we have a compartment for ‘procedures, there is a catheterisation pack, in-out catheter, Instilliagel, Amnihook, 0.9% sodium chloride 1000ml and a IV giving set in here along with disinfectant wipes. In the lower part in each compartment from left to right there are: 1) Waste bags (black, orange, yellow, and linen), cable ties, plastic sheet 2) Sanitary pads and swabs 3) PPE - gloves (both sterile and non-sterile), aprons and goggles
We then have a placenta pot with a lid below filled with inco pads. New 2018
Below is the ‘procedures’ compartment in more detail
Community Midwife Equipment List Clinical Guideline V2.0 Page 10 of 17
Place your delivery pack on the top (ours is in the blue bag). New 2018
Images - Copyright Royal Cornwall Hospitals Trust 2018
2.7. Intrapartum transfer from a home birth: Any community midwife undertaking an intrapartum transfer from a home birth must ensure that they have all equipment that may be required during the transfer, with them during the transfer. This must include all equipment listed above.
Community Midwife Equipment List Clinical Guideline V2.0 Page 11 of 17
3. Monitoring compliance and effectiveness
Element to be monitored
Weekly checking of ‘grab bags’ Entonox equipment checks
Lead Community Team Leaders
Tool Completion of check lists Records of entonox checks
Frequency As required
Reporting arrangements
Through Community Team Leaders
Acting on recommendations and Lead(s)
Team leaders to take appropriate action
Change in practice and lessons to be shared
Through Team Leaders Forum
4. Equality and Diversity 4.1. This document complies with the Royal Cornwall Hospitals NHS Trust service Equality and Diversity statement which can be found in the 'Equality, Inclusion & Human Rights Policy' or the Equality and Diversity website.
4.2. Equality Impact Assessment
The Initial Equality Impact Assessment Screening Form is at Appendix 2.
Community Midwife Equipment List Clinical Guideline V2.0 Page 12 of 17
Appendix 1. Governance Information
Document Title Community Midwife Equipment List Clinical Guideline V2.0
Date Issued/Approved: 4th July 2019
Date Valid From: July PRG
Date Valid To: July 2022
Directorate / Department responsible (author/owner):
Trudie Roberts, Community Matron Obs and Gynae Directorate
Contact details: 01872 252270
Brief summary of contents
To provide community midwives with a list of equipment that they should carry individually and the availability of additional equipment
Suggested Keywords: VTE, risk, assessment, venous, thromboprophylaxis, Fragmin, TEDS
Target Audience RCHT CFT KCCG
Executive Director responsible for Policy:
Medical Director
Date revised: 4th July 2019
This document replaces (exact title of previous version):
Community Midwifery Equipment – Clinical Guideline V1.4
Approval route (names of committees)/consultation:
Clinical Guidelines Group Maternity Governance Obstetrics and Gynaecology Directorate Policy Review group Divisional Board for approval
Care Group General Manager confirming approval processes
Debra Shields, Care Group Manager
Name and Post Title of additional signatories
Not required
Name and Signature of Care Group/Directorate Governance Lead confirming approval by specialty and care group management meetings
{Original Copy Signed}
Name: Caroline Amukusana
Signature of Executive Director giving approval
{Original Copy Signed}
Community Midwife Equipment List Clinical Guideline V2.0 Page 13 of 17
Publication Location (refer to Policy on Policies – Approvals and Ratification):
Internet & Intranet Intranet Only
Document Library Folder/Sub Folder Clinical/Midwifery and Obstetrics
Links to key external standards None required
Related Documents: None
Training Need Identified? No
Version Control Table
Date Version
No Summary of Changes
Changes Made by (Name and Job Title)
2003 V1.0 Initial version Jan Clarkson Community midwife
2010 V1.1 Updated Jan Clarkson Maternity risk manager
1 Nov 13 V1.2 Updated and added intrapartum grab bag for birth centres
Jan Clarkson Maternity risk manager
1.9.2016 V1.3
Updated to include neonatal thermometer, C02 monitor, intrapartum transfer form and SBARD sticker, IV administration and bladder filling equipment
Community Team Leaders and Rob Holmes, Consultant Obstetrician, Obs & Gynae Directorate
7th June 2018
V1.4
Updated to include section 2.6 - photos of new community bag and packing schedule and addition of Appendix 3 Misoprostol order sheet.
Trudie Roberts, Community matron, Charlotte Boswell and Lizzie Anstey, community midwives
4th July 2019
V1.5 Updated to change the amount of sodium carried for bladder re-filling and IV infusion.
Rob Holmes, Consultant Obstetrician, Obs & Gynae Directorate
All or part of this document can be released under the Freedom of Information
Act 2000
This document is to be retained for 10 years from the date of expiry. This document is only valid on the day of printing
Controlled Document
This document has been created following the Royal Cornwall Hospitals NHS Trust Policy for the Development and Management of Knowledge, Procedural and Web
Documents (The Policy on Policies). It should not be altered in any way without the express permission of the author or their Line Manager.
Community Midwife Equipment List Clinical Guideline V2.0 Page 14 of 17
Appendix 2. Initial Equality Impact Assessment Form
Name of the strategy / policy /proposal / service function to be assessed
Community Midwife Equipment List Clinical Guideline V2.0
Directorate and service area: Obs & Gynae Directorate
New or existing document: Existing
Name of individual completing assessment: Trudie Roberts
Telephone: 01872 252684
1. Policy Aim* Who is the strategy / policy / proposal / service function aimed at?
To provide community midwives with a list of equipment that they should carry individually and the availability of additional equipment.
2. Policy Objectives*
To ensure community midwives have up to date equipment which is in good working order
3. Policy – intended Outcomes*
Ensure equipment is available as required
4. *How will you measure the outcome?
Compliance monitoring tool
5. Who is intended to benefit from the policy?
Pregnant, labouring and post-natal women
6a Who did you consult with b). Please identify the groups who have been consulted about this procedure.
Workforce Patients Local groups
External organisations
Other
x
Clinical Guidelines Group Maternity Governance Obstetrics and Gynaecology Directorate Policy Review group Divisional Board for approval
What was the outcome of the consultation?
Guideline agreed
Community Midwife Equipment List Clinical Guideline V2.0 Page 15 of 17
Are there concerns that the policy could have differential impact on:
Equality Strands: Yes No Unsure Rationale for Assessment / Existing Evidence
Age x
Sex (male,
female, trans-gender / gender reassignment)
x
Race / Ethnic communities /groups
x
Disability - Learning disability, physical impairment, sensory impairment, mental health conditions and some long term health conditions.
x
Religion / other beliefs
x
Marriage and Civil partnership
x
Pregnancy and maternity
x
Sexual Orientation, Bisexual, Gay, heterosexual, Lesbian
x
You will need to continue to a full Equality Impact Assessment if the following have been highlighted:
You have ticked “Yes” in any column above and
No consultation or evidence of there being consultation- this excludes any policies which have been identified as not requiring consultation. or
Major this relates to service redesign or development
8. Please indicate if a full equality analysis is recommended. Yes No x
9. If you are not recommending a Full Impact assessment please explain why.
Not indicated
7. The Impact Please complete the following table. If you are unsure/don’t know if there is a negative impact you need to repeat the consultation step.
Community Midwife Equipment List Clinical Guideline V2.0 Page 16 of 17
Date of completion and submission
4th July 2019
Members approving screening assessment
Policy Review Group (PRG) APPROVED
This EIA will not be uploaded to the Trust website without the approval of the Policy Review Group. A summary of the results will be published on the Trust’s web site.
Community Midwife Equipment List Clinical Guideline V2.0 Page 17 of 17
Appendix 3 (New 2018)
Misoprostol 200mcg tablets Community Midwives order sheet.
Date
Drug
Strength
Volume
Ordered by
Dispensed by Print
Dispensed by Signed
Received by Print
Received by Print
Given to Print or patient label
Strength given
Given by Print
Given by Sign
On what date
Emergency pharmaceutical treatment of postpartum haemorrhage in the community setting
First line Second Line Third Line
Syntometrine 500mcg Ergometrine with 5 units oxytocin. IM OR
Ergometrine 500mcg Im Misoprostol 800mcg PR
Oxytocin 10 units IM (raised BP)
Recommended