Background: midwives are the health professionals most involved in the care of women and newborns, scientific literature shows how the care provided by midwives is associated with better maternal and fetal health outcomes and an improvement in the quality of care. The identification of a dataset of obstetric interventions would allow us to document obstetric action and provide evidence of the effectiveness of the interventions and the quality of the care provided. The term obstetric intervention includes all activities, based on clinical judgment and knowledge, that the midwife provides with the aim of improving maternal, neonatal and community health outcomes in general. A study was recently concluded (development phase) which, through a literature review, developed the preliminary evidence-based version of the Midwifery Minimum Dataset (MMDS) specific for the Italian context which includes 165 obstetric interventions. Obstetric interventions require a specific definition that must be developed through building consensus among interested parties to develop the Italian taxonomy of the classification of interventions in obstetrics. The objective of the present study (Consensus Phase) is to initiate the consensus process for the validation of the Midwifery Interventions Classification (MIC) classification and taxonomy through the first round of Delphi survey. Method: a multi-round Delphi study was designed with the involvement of three panels of stakeholders: midwives, researchers and users of maternity services. The first Delphi round was carried out between May and June 2023, the data entry took place between July-August 2023 and the analysis of the same in September 2023. All participants, through an online survey, evaluated each obstetric intervention using a nine-point Likert scale. To define consensus, the 70/15% method was chosen, according to which an evaluation should be included if more than 70% of participants assigned a score between 7 and 9 and less than 15% of participants assigned a score between 1 and 3. Results: The first round was completed by 125 participants: 82 midwives, 12 researchers and 31 service users. 165 obstetric interventions were evaluated and a consensus level of 81% was obtained. Participants agreed in evaluating 134 obstetric interventions. Of these, 133 were rated as essential overall and 1 (Int_3: Cup feeding: infant) was rated as not important. From the analysis of the suggestions contained in the open-ended question, eight interventions were modified and two interventions added, therefore the number of interventions reported in the MIC classification from the first phase of the study (Development phase) to the end of the first round of the Delphi was modified from 165 to 166 as two interventions were added and two were merged. Conclusions: in the first round of the Delphi, 165 interventions were evaluated and a consensus of 81% was obtained. The MIC classification from the first phase of the study to the end of the first round of the Delphi was changed from 165 to 166 interventions. Keyword: maternal and neonatal health, midwifery, quality indicators
Background: le ostetriche sono i professionisti sanitari maggiormente coinvolti nell’assistenza alla donna ed al neonato, la letteratura scientifica mostra come l’assistenza erogata dalle ostetriche sia associata a migliori esiti di salute materni e fetali e ad un miglioramento della qualità delle cure. L’identificazione di un dataset di interventi ostetrici permetterebbe di documentare l’agire ostetrico e di fornire la prova dell’efficacia degli interventi e della qualità delle cure erogate. Il termine intervento ostetrico comprende tutte le attività, basate sul giudizio clinico e sulla conoscenza, che l’ostetrica fornisce con l’obiettivo di migliorare gli esiti di salute materni, neonatali e della comunità in generale. Recentemente è stato concluso uno studio (Fase di sviluppo) che, attraverso una revisione di letteratura, ha sviluppato la versione preliminare evidence-based del Midwifery Minimum Dataset (MMDS) specifica per il contesto italiano che comprende 165 interventi ostetrici. Gli interventi ostetrici richiedono una definizione specifica che deve essere sviluppata attraverso la costruzione del consenso delle parti interessate per sviluppare la tassonomia italiana della classificazione degli interventi in ostetricia. L’obiettivo del presente studio (Fase del consenso) è quello di avviare il processo di consenso per la validazione della classificazione e tassonomia della Midwifery Interventions Classification (MIC) attraverso il primo round di indagine Delphi. Metodo: è stato progettato uno studio Delphi multi round con il coinvolgimento di tre panel di stakeholder: ostetriche/i, ricercatori ed utenti dei servizi di maternità. Il primo round Delphi è stato effettuato tra maggio e giugno 2023, l’inserimento dei dati è avvenuto tra luglio-agosto 2023 e l’analisi degli stessi a settembre 2023. Tutti i partecipanti, attraverso una survey online, hanno valutato ciascun intervento ostetrico utilizzando una scala di Likert a nove punti. Per definire il consenso è stato scelto il metodo 70/15% secondo cui una valutazione va inclusa se più del 70% dei partecipanti ha assegnato un punteggio tra 7 e 9 e meno del 15% dei partecipanti ha assegnato un punteggio tra 1 e 3. Risultati: il primo round è stato completato da 125 partecipanti: 82 ostetriche, 12 ricercatori e 31 utenti dei servizi. Sono stati valutati 165 interventi ostetrici ed è stato ottenuto un grado di consenso dell’81%. I partecipanti sono stati concordi nel valutare 134 interventi ostetrici. Di questi, 133 sono stati valutati complessivamente come essenziali e 1 (Int_3: Alimentazione con tazza: neonato) è stato valutato come non importante. Dall’analisi dei suggerimenti contenuti nella domanda a risposta aperta sono stati modificati otto interventi ed aggiunti due interventi, pertanto il numero degli interventi riportati nella classificazione MIC dalla prima fase dello studio (Fase di sviluppo) al termine del primo round del Delphi è stato modificato da 165 a 166 in quanto sono stati aggiunti due interventi e due sono stati accorpati. Conclusioni: nel primo round del Delphi sono stati valutati 165 interventi ed ottenuto un consenso dell’81%. La classificazione MIC dalla prima fase dello studio al termine del primo round del Delphi è stata modificata da 165 a 166 interventi. Parole chiave: salute materna e neonatale, ostetricia, indicatori di qualità
Risultati preliminari dello studio Midwifery Intervention Classification (MIC): un'indagine Delphi
BERNASCONI, LAURA
2022/2023
Abstract
Background: midwives are the health professionals most involved in the care of women and newborns, scientific literature shows how the care provided by midwives is associated with better maternal and fetal health outcomes and an improvement in the quality of care. The identification of a dataset of obstetric interventions would allow us to document obstetric action and provide evidence of the effectiveness of the interventions and the quality of the care provided. The term obstetric intervention includes all activities, based on clinical judgment and knowledge, that the midwife provides with the aim of improving maternal, neonatal and community health outcomes in general. A study was recently concluded (development phase) which, through a literature review, developed the preliminary evidence-based version of the Midwifery Minimum Dataset (MMDS) specific for the Italian context which includes 165 obstetric interventions. Obstetric interventions require a specific definition that must be developed through building consensus among interested parties to develop the Italian taxonomy of the classification of interventions in obstetrics. The objective of the present study (Consensus Phase) is to initiate the consensus process for the validation of the Midwifery Interventions Classification (MIC) classification and taxonomy through the first round of Delphi survey. Method: a multi-round Delphi study was designed with the involvement of three panels of stakeholders: midwives, researchers and users of maternity services. The first Delphi round was carried out between May and June 2023, the data entry took place between July-August 2023 and the analysis of the same in September 2023. All participants, through an online survey, evaluated each obstetric intervention using a nine-point Likert scale. To define consensus, the 70/15% method was chosen, according to which an evaluation should be included if more than 70% of participants assigned a score between 7 and 9 and less than 15% of participants assigned a score between 1 and 3. Results: The first round was completed by 125 participants: 82 midwives, 12 researchers and 31 service users. 165 obstetric interventions were evaluated and a consensus level of 81% was obtained. Participants agreed in evaluating 134 obstetric interventions. Of these, 133 were rated as essential overall and 1 (Int_3: Cup feeding: infant) was rated as not important. From the analysis of the suggestions contained in the open-ended question, eight interventions were modified and two interventions added, therefore the number of interventions reported in the MIC classification from the first phase of the study (Development phase) to the end of the first round of the Delphi was modified from 165 to 166 as two interventions were added and two were merged. Conclusions: in the first round of the Delphi, 165 interventions were evaluated and a consensus of 81% was obtained. The MIC classification from the first phase of the study to the end of the first round of the Delphi was changed from 165 to 166 interventions. Keyword: maternal and neonatal health, midwifery, quality indicatorsÈ consentito all'utente scaricare e condividere i documenti disponibili a testo pieno in UNITESI UNIPV nel rispetto della licenza Creative Commons del tipo CC BY NC ND.
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https://hdl.handle.net/20.500.14239/16787