- Midwives working in Maternity Triage should include the number of previous Triage attendances – total and most recent – in their documentation.
- Women who present to Maternity Triage not having attended any scheduled care should have an appointment made at their consultant’s antenatal clinic.
- If a woman attends Maternity Triage on more than two occasions within the same month with the same presenting symptom
- There should be a discussion with the on-call obstetric consultant to determine plan of care.
- It should prompt a face-to-face review with a middle grade obstetrician (at a minimum) to determine plan of care.
- The woman’s own obstetric consultant and primary midwife should be advised, so that appropriate follow up can be arranged. This may include an appointment at their named obstetric consultant’s antenatal clinic, or email communication.
- If there is concern about a woman’s safety, it is reasonable to offer admission. A clearly documented care plan should include an appointment at their named obstetric consultant’s next antenatal clinic, along with offering referrals to the Blossom Team and/or other agencies if appropriate.
- Midwifery care and medical reviews in Triage should be clearly documented in Badger by the clinician providing that care.
Frequent Attendance for Unscheduled Maternity care in Triage and DCU (1202)
Warning
Objectives
This document offers guidance on developing care plans for women who have frequent attendances for unscheduled maternity care at Maternity Triage or Maternity Day Care Units.
Audience
This guideline is for the multi-professional maternity team including midwives, obstetricians, and maternity support workers.
Women attending triage on more than one occasion within 24 hours in suspected latent phase labour should be offered admission. Please refer to Latent phase labour (409) | Right Decisions for further information on prolonged latent phase management.
Frequent attendance for unscheduled (emergency) maternity care is noted within our Triage and Day Care Units.
It is a complex issue - the right care at the right time needs to be facilitated as delays in assessment, diagnosis and appropriate care, can lead to perinatal and maternal morbidity and mortality. However, the impact of inappropriate attendances on wider service provision cannot be overlooked.
Underlying physical, social or psychological concerns may be a reason for frequent attendances for unscheduled maternity care. The ongoing care plan should be cognisant of this, with frequent attendance triggering additional care to ensure that any underlying concerns are addressed.