Background - The TrendCare Patient Dependency
System is currently used by a large number of maternity Services
across Australia, New Zealand and Singapore. In 2012, 2013 and
2014 validation studies were initiated in all three countries to validate
the acuity tools used for women in labour, and postnatal mothers and
babies. This paper will present the findings of the validation study.
Aim - The aim of this study was to; identify if the care hours
provided by the TrendCare acuity system was an accurate reflection
of the care required by women and babies; obtain evidence of
changes required to acuity indicators and/or category timings to
ensure the TrendCare acuity system remains reliable and valid across
a range of maternity care models in three countries.
Method - A non-experimental action research methodology was
used across maternity services in four District Health Boards in New
Zealand, a large tertiary and a large secondary maternity service in
Singapore and a large public maternity service in Australia.
Standardised data collection forms and timing devices were used to
collect midwife contact times, with women and babies included in the
study. Rejection processes excluded samples when care was not
completed/rationed, and contact timing forms were incomplete. The
variances between actual timed midwife/mother/baby contact and the
TrendCare acuity category times were identified and investigated.
Results - Thirty two (88.9%) of the 36 TrendCare acuity category
timings, fell within the variance tolerance levels when compared to
the actual timings recorded for midwifery care. Four (11.1%)
TrendCare categories provided less minutes of care than the actual
timings and exceeded the variance tolerance level. These were all
night shift category timings. Nine postnatal categories were not able
to be compared as the sample size for these categories was
statistically insignificant. 100% of labour ward TrendCare categories
matched actual timings for midwifery care, all falling within the
variance tolerance levels.
The actual time provided by core midwifery staff to assist lead
maternity carer (LMC) midwives in New Zealand labour wards
showed a significant deviation to previous studies. The findings of
the study demonstrated the need for additional time allocations in
TrendCare to accommodate an increased level of assistance given to
Conclusion - The results demonstrated the importance of regularly
validating the TrendCare category timings with actual timings of the
care hours provided. It was evident from the findings that variances
to models of care and length of stay in maternity units have increased
midwifery workloads on the night shift. The level of assistance
provided by the core labour ward staff to the LMC midwife has
Outcomes - As a consequence of this study, changes were made to
the night duty TrendCare maternity categories, additional acuity
indicators were developed and times for assisting LMC midwives in
labour ward increased. The updated TrendCare version was delivered
to maternity services in 2014.
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