IMMO v1
Research type
Research Study
Full title
IMproving the practice of foetal heartrate MOnitoring with cardiotocography for safer childbirth
IRAS ID
237331
Contact name
Mary Dixon-Woods
Contact email
Sponsor organisation
University of Cambridge - School of Clinical Medicine
Duration of Study in the UK
1 years, 8 months, 30 days
Research summary
Maternity safety is a major concern in the UK and in health systems globally. Sub-optimal fetal heart rate monitoring in labour, especially when involving electronic fetal monitoring (EFM) using CardioTocoGraphy (CTG), has been identified as one of the most common causes of avoidable harm. Technical solutions have not been successful in the past; effective improvement strategies, including training, are likely to require an in-depth understanding of both the social and technical mechanisms underpinning EFM classification, interpretation and subsequent actions. However, these mechanisms have not been thoroughly described.
The overarching aim of this project is to advance current knowledge of the types of errors, hazards and failure modes that may occur in the process of classifying, interpreting, and responding to, CTG traces.
First, we will conduct an ethnographic study to increase our understanding of how intrapartum EFM is conducted in routine clinical practice, and what contextual, cultural and social factors for the maternity team and parent/s may influence this process. Second, based on the findings, as well as an analysis of existing patient safety literature, we will build a framework of the errors, hazards and failure modes that may affect EFM in labour.
The end product of this study will be a theoretically and empirically grounded framework of the errors, hazards and failure modes in the interpretation of and reaction to intrapartum CTG traces. This project is the first stage of a broader research programme which aims to develop and test an intervention to improve the practice of intrapartum EFM.REC name
West Midlands - South Birmingham Research Ethics Committee
REC reference
18/WM/0292
Date of REC Opinion
24 Sep 2018
REC opinion
Favourable Opinion