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Inequalities in birth before arrival at hospital in South West England: a multi-methods study of neonatal hypothermia and emergency medical services call handler advice.

Goodwin, Laura, Kirby, Kim, McClelland, Graham, Beach, Emily, Bedson, Adam, Benger, Jonathan, Deave, Tioty, Osborne, Ria, McAdam, Helen, McKeon-Carter, Roisin, Miller, Nick, Taylor, Hazel and Voss, Sarah (2024) Inequalities in birth before arrival at hospital in South West England: a multi-methods study of neonatal hypothermia and emergency medical services call handler advice. Inequalities in birth before arrival at hospital in South West England: a multimethods study of neonatal hypothermia and emergency medical services call handler advice, 14 (4). ISSN 2044-6055

Item Type: Article

Abstract

Objectives: To examine inequalities in birth before arrival (BBA) at hospital in South West England, understand which groups are most likely to experience BBA and how this relates to hypothermia and outcomes (phase A). To investigate opportunities to improve temperature management advice given by emergency medical services (EMS) call handlers during emergency calls regarding BBA in the UK (phase B).
Design: A two phase multimethod study. Phase A analysed anonymised data from hospital neonatal records between January 2018 and January 2021. Phase B analysed anonymised EMS call transcripts, followed by focus groups with National Health Service (NHS) staff and patients.
Setting: Six hospital trusts in South West and two EMS providers (ambulance services) in South West and North East England.
Participants: 18 multidisciplinary NHS staff and 22 members of the public who had experienced BBA in the UK.
Results: 35%(64/184) of babies conveyed to hospital were hypothermic on arrival. When compared with national data on all births in the south west we found higher percentages of women with documented safeguarding concerns at booking, previous live births and late bookers (booking their pregnancy >13 weeks gestation). These women may therefore be more likely to experience BBA. Preterm babies, babies to first time mothers and babies born to mothers with disability or safeguarding concerns at booking were more likely to be hypothermic following BBA. Five main themes emerged from qualitative data on call handler advice 1) importance placed on neonatal temperature, 2) advice on where the baby should be placed following birth 3) advice on how to keep the baby warm 4) timing of temperature management advice and 5) clarity and priority of instructions.
Conclusion: findings identified factors associated with BBA and neonatal hypothermia following BBA. Improvements to EMS call handler advice could reduce the number of babies arriving at hospital hypothermic.

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More Information

Depositing User: Helen McAdam

Identifiers

Item ID: 18930
Identification Number: https://doi.org/10.1136/bmjopen-2023-081106
ISSN: 2044-6055
URI: http://sure.sunderland.ac.uk/id/eprint/18930
Official URL: https://bmjopen.bmj.com/content/14/4/e081106

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Catalogue record

Date Deposited: 07 Apr 2025 12:45
Last Modified: 07 Apr 2025 12:45

Contributors

Author: Laura Goodwin
Author: Kim Kirby
Author: Graham McClelland
Author: Emily Beach
Author: Adam Bedson
Author: Jonathan Benger
Author: Tioty Deave
Author: Ria Osborne
Author: Helen McAdam
Author: Roisin McKeon-Carter
Author: Nick Miller
Author: Hazel Taylor
Author: Sarah Voss

University Divisions

Faculty of Health Sciences and Wellbeing > School of Nursing and Health Sciences

Subjects

Sciences > Health Sciences

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