Intrapartum clinical guideline for monitoring and managing a woman during labour

Abstract

This research study explored and described a partogram as a clinical practice guideline for monitoring and managing women during labour at Vhembe District of Limpopo province. A qualitative, explorative, descriptive and contextual design was used in order to achieve the study objectives. Purposive sampling was carried out to select three hospitals in order to obtain comprehensive data from the district. The research study was conducted in three phases. Face-to-face semi-structured interviews were conducted with 17 midwives who were selected conveniently from the three hospitals. Document study was also conducted on 24 partograms that were conveniently selected from the three hospitals on the days that interviews were conducted, using a self-designed checklist. Tesch’s eight steps of qualitative data analysis were used to analyse the data, and simple, descriptive statistics using frequencies were used to analyse the data obtained from the document study. Four themes that emerged from the data are: benefits of implementing the partogram, challenges experienced, attitudes of staff and evaluation on how the guideline is being implemented in the wards, including giving feedback. These aspects were indicated as pivotal in the implementation of the guideline in monitoring a woman during labour. The findings on document study revealed gaps in recording, mostly on aspects that needed frequent observations and on aspects in which resources that needed to be used in monitoring were lacking. The strategies to improve the implementation of a guideline were developed based on the research findings, sent to one of the hospitals for review and comments were included in the discussions. It is recommended that in-service training on the implementation of the partogram be conducted regularly for midwives. Hospital management and supervisors need to provide support, enough staff and equipment in order to enable midwives to use the partogram