Why choose forceps over ventouse? A qualitative study exploring contextual factors in decision making. (7th June 2011)

• Record Type: Journal Article
• Authors: Umranikar, A; Fenwick, A; Wiles, R; Cullen, J; Mountfield, J; Cheong, Y
• Is Part Of: Archives of disease in childhood. Volume 96(2011)Supplement 1
• Page Start: Fa95
• Page End: Fa95
• Publication Date: 2011-06-07
• Subjects: Infants -- Diseases -- Periodicals; Newborn infants -- Diseases -- Periodicals; Fetus -- Diseases -- Periodicals; 618.920105
• DOI: 10.1136/archdischild.2011.300162.69
• Languages: English
• ISSNs: 1359-2998

Abstract

Abstract : Background: Clinical guidelines on instrumental deliveries are mainly skill based. The objective of this study was to identify factors which influence clinicians' decision making in conducting an instrumental delivery. Methods: The study has utilised a qualitative case-study approach comprising observation of the decision-making process during deliveries and follow-up interviews with clinicians. Interview data were transcribed and used alongside observational notes to analyse decision making in each case. Results: Data were collected from 23 cases, the majority of which (n=16) were forceps deliveries. A range of factors related to equipment, training and hospital culture were identified as being discouraging to the use of ventouse. Conclusion: Hospital context and culture have a central role in influencing clinician's decision making. Understanding these factors is a crucial first step in assessing appropriate practice and identifying interventions to change practice.