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Epidurals: myths and old wives tales- what are the midwives telling our patients?
Abstract Number: F 18
Abstract Type: Other
Introduction: Midwives’ knowledge regarding epidural analgesia requires further evaluation in the United Kingdom. Studies in Australia have demonstrated a 56% correct response rate in epidural complications knowledge amongst registered nurses and midwives(1). We conducted a survey to evaluate midwives' knowledge about this method of analgesia prior to deployment of an educational programme.
Methods: A nine-question survey link was sent via email to all midwives registered in our hospital. Participants were asked to state their primary location of work: community, labour ward, antenatal or postnatal ward or other. Questions reflected those that are commonly asked by patients to anaesthetists, those in which epidural placement has obstetric implications and those where common midwife misunderstanding has been anecdotally recognised. The entire cohort of midwives was asked to complete the on-line survey. Subsequent collection and analysis of results was performed using surveymonkey.com.
Results: Fifty four responses were recorded from one hundred and fourteen survey completion requests (response rate=47%). The breakdown based on midwife primary location is shown in Table 1.1. There was considerable variation in the percentage of midwives answering questions correctly with the highest proportion for a single question being 94% and the lowest being 37% (Table 1.2). There appears to be a divergence based on primary location of work (community vs labour ward) in epidural knowledge. This can be illustrated especially with regard to two specific points of epidural knowledge (Table 1.3): presence of the motor block and the likelihood of causing a caesarean section.
Conclusions: Inevitably, the likely first healthcare professional to be asked questions regarding epidurals are midwives. The results of the survey illustrate that there is less than uniform consensus and accuracy in midwives’ knowledge regarding epidural analgesia. It is recognised in this study that the suboptimal response rate may skew results. Nevertheless, there were few questions in our survey which were answered correctly by more than 90% participants. With regard to epidural knowledge, there is clearly a need for better education. Further studies of a larger cohort may elucidate further deficiencies in knowledge which may benefit from anaesthetic-led midwives education.
1.Bird A, et al. Registered nurses’ and midwives’ knowledge of epidural analgesia. Collegian 2009;16(4):193-200.