ICID > Clinical Management > Maternity Neonatal > Communication and Ward Rounds  

Communication and Ward Rounds 

  • 1. Indications
  • 2. Clinical Management
  • 3. Patient Information
  • 4. Audit
  • 5. Evidence Base
  • 6. Appendices
  • 1. Indications

    1.1 Background

    The labour ward reviews are aimed at improving communication and maximizing the potential for cross professional education. The purpose of these reviews is to encourage discussion and mutual education between doctors and midwives and improve supervision of all learners.

    1.2 Aim/purpose

    The senior midwife and on call medical staff should meet at each handover of shift to discuss high risk and abnormal cases.  The senior midwife updates the medical staff coming on duty with the aid of the white board. The consultant obstetrician is present at the beginning of their on call period and is in contact with the midwifery and medical staff throughout the shift.

    1.3 Patient/client group

    All patients/clients admitted to the maternity unit via the labour ward.

    All patients/clients admitted elsewhere within Salisbury Foundation Trust except those in 1.4.

    1.4 Exceptions/ contraindications


    1.5 Options

    2. Clinical Management

    2.1 Staff & equipment

    The appropriate members of staff are present.

    The ward office is conducive to holding sessions by being quiet and ensuring confidentiality by closing the doors.

    There is access to the White board and the correct information is visible on the board, including patient’s name, gestation, parity, diagnosis and consultant obstetrician.

    2.2 Method/procedure

    All normal cases are identified on the labour ward white board in black pen and a personal handover is given midwife to midwife.

    Abnormal and high risk cases are identified on the labour ward white board in red pen.

    The senior midwife will prioritise the high risk cases to be reviewed and discuss with  the doctors.

    All high risk cases must be reviewed and a plan of care written in the notes.

    Any normal case which becomes abnormal i.e. non – ressuring CTG or poor progress in labour, will be reviewed by the senior midwife and referred tot he obstetrician.

    The management of women at high risk will be managed by the medical team.

    2.3 Potential complications / Risk Management

    The midwife who is caring for the patient must be able to identify deviations from the normal and refer appropriately to the medical team.

    When there is a sudden change in the condition of a patient emergency medical assistance must be summoned immediately.

    Clear documentation of all care given and plans of care to be clearly and legibly recorded in the maternity records.

    All  midwives have direct access to a consultant at all times and any midwife is able to bypass the senior midwife and doctor if they are not in agreement or have concerns regarding the management of the care provided to a woman.

    2.4 After care

    Midwives coming on duty on the labour ward report to the senior midwife co-ordinating the shift and will be allocated to care for a woman/women.

    Handover will take place within the labour ward with the senior midwife giving a brief overview of all cases. The midwife taking over the care of a woman will have a personal handover from the previous midwife in the room.

    3. Patient Information

    The importance of identifying those cases which are high risk and explaining to the patient the need to liase with medical staff to plan and manage care.

    The needs of the mother and baby must be the primary focus of practice.

    The mother should be enabled to make decisions about her care based on her needs and informed choice.

    4. Audit

    4.1 Audit Indicators

    100% of high risk cases will be discussed with medical staff at each handover.

    4.2 Audit design

    100% of high risk cases will have the plan of care recorded in the maternity records.

    4.3 User Involvement

    All staff will be given the opportunity to discuss their role in the mangement of these cases and be involved in planning of care.

    5. Evidence Base

    5.1 Sources of information

    1. Nursing and Midwifery Council (2004)Midwives Rules and Standards. NMC, London

    2. Nursing and Midwifery Council (2004) Code of Professional Conduct .NMC, London.

    3. Salisbury Foundation Trust. (2004) Guidelines for right of referral to a registered medical practitioner.

    5.2 Summary of evidence, review and recommendations

    6. Appendices

    Document Owner Susan Howard 
    Review Date
    Document Status
    Revision Number