A National Clinical Quality Improvement Project to Improve the Assessment and Management of Perineal Trauma 2006-2011

Investigators: D,Bick, C,Kettle, S,Macdonald, K,Ismail, R, Hills
Project Funding: The Health Foundation

In the UK approximately 400,000 women sustain perineal injury each year as a result of spontaneous vaginal birth. The assessment and management of perineal trauma is a core component of routine maternity care however, this remains an area of practice with huge gaps between the care given and established professionally agreed standards. This quality improvement project will engage clinicians and users of the maternity service to assess current perineal management and establish if the introduction of a standardised training package will have significant impact on women’s experiences, levels of morbidity, clinical practice and the use of NHS resources.PEARLS is a matched pair cluster trial, which is being conducted in 22 maternity units across the UK. Units within a matched pair will be randomised to implement the study intervention either early or late in the study period. Prior to developing the intervention and deciding on study outcomes, a Delphi survey and a consensus conference were held to identify what women, who previously suffered perineal trauma during childbirth, considered to be important outcomes for them. Findings from this preliminary work (which will be reported elsewhere) and other outcomes including women’s experiences of perineal pain and pain on activity, breastfeeding uptake and duration and psychological well-being.

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PErineal Assessment and Repair e-Learning System: an internet based training package (PEARLS.net) 2010-2011

Investigators: K, Ismail, C, Kettle, D, Bick , M, Abdel-Maguid
Project Funding: The Health Foundation

This project follows on from the PErineal Assessment and Repair Longitudinal Study (PEARLS). The PEARLS training package included an interactive CD-ROM to assist midwives and obstetricians to develop basic surgical skills, refresh core information, and maintain competency when undertaking the assessment and management of perineal trauma. The content of the PEARLS CD-ROM will be developed into an innovative web-based e-learning training package to enable practitioners to access the training materials, at their convenience, in order to achieve competency in the management of perineal trauma at a relatively low cost. Piloting of the CD and review by internationally acknowledged experts will be completed prior to the launch of the tool.