UK consensus guidelines for the delivery of unexpected news in obstetric ultrasound: The ASCKS framework. (November 2020)

• Record Type: Journal Article
• Authors: Johnson, Judith; Arezina, Jane; Tomlin, Liz; Alt, Siobhan; Arnold, Jon; Bailey, Sarah; Beety, Hannah; Bender-Atik, Ruth; Bryant, Louise; Coates, Jen; Collinge, Sam; Fishburn, Jo; Fisher, Jane; Fowler, Jan; Glanville, Tracey; Hallett, Julian; Harley-Roberts, Ailith; Harrison, Gill; Horwood, Karen; Hynes, Catriona; Kimm, Lindsay; McGuinness, Alison; Potter, Lucy; Powell, Liane; Ramsay, Janelle; Shakes, Pieta; Sicklen, Roxanne; Sims, Alexander; Stacey, Tomasina; Sumra, Anushka; Thomas, Samantha; Todd, Karen; Torrington, Jacquie; Trueman, Rebecca; Walsh, Lorraine; Watkins, Katherine; Yaz, Gill; Hardicre, Natasha K;
• Is Part Of: Ultrasound. Volume 28:Number 4(2020:Nov.)
• Page Start: 235
• Page End: 245
• Publication Date: 2020-11
• Subjects: Ultrasound -- sonography -- communication -- news delivery -- guidelines -- training; Ultrasonic imaging -- Periodicals; Ultrasonography -- Periodicals; 616.0754305
• DOI: 10.1177/1742271X20935911
• Languages: English
• ISSNs: 1742-271X

Abstract

Background: Studies indicate there is a need to improve the delivery of unexpected news via obstetric ultrasound, but there have been few advances in this area. One factor preventing improvement has been a lack of consensus regarding the appropriate phrases and behaviours which sonographers and ultrasound practitioners should use in these situations. Aims: To develop consensus guidelines for unexpected news delivery in Early Pregnancy Unit and Fetal Anomaly Screening Programme NHS settings. Methods: A workshop was conducted to identify priorities and reach consensus on areas of contention. Contributors included interdisciplinary healthcare professionals, policy experts, representatives from third-sector organisations, lay experts and academic researchers ( n = 28). Written and verbal feedback was used to draft initial guidance which was then circulated amongst the wider writing group ( n = 39). Revisions were undertaken until consensus was reached. Results: Consensus guidelines were developed outlining the behaviours and phrases which should be used during scans where unexpected findings are identified. Specific recommendations included that: honest and clear communication should be prioritised, even with uncertain findings; technical terms should be used, but these should be written down together with their lay interpretations; unless expectant parents use other terminology (e.g. 'foetus'), the term 'baby' should be used as a default, even in early pregnancy; at the initial news disclosure, communication should focus on information provision. Expectant parents should not be asked to make decisions during the scan. Conclusions: These recommendations can be used to develop and improve news delivery interventions in obstetric ultrasound settings. The full guidelines can be accessed online as supplemental material and athttps://doi.org/10.5518/100/24 .