Has anyone else got/asked Euroking to set up a separate Smoking/CO questionnaire on E3 (it's obviously being discussed as you can see below (from our Smoking Cessation midwife)?
I attended a meeting with XXXXX (DGS CCG)on Wednesday regarding the smoking in pregnancy agenda. During the meeting she raised concerns about the quality of data recorded for SATOD across Kent and the inconsistencies in the timing at which SATOD is recorded between the trusts and whether smoking status is verified with CO readings.
In view of these concerns she has mandated a uniform approach across Kent to the timing of collection of SATOD data. The other Trusts are keen that this is collected at 36 weeks, and have stated that this recorded on E3. Is this something that we can also set up on our E3? Perhaps a CO reading, a question about smoking status, and whether or not a referral has been made?
I’m happy to notify all community midwives of this change and the need to record this and perform a CO reading for all women and to do this in ANC as well once we are set up and ready to go.
I have considered the other options that I could propose but they’re not as feasible as this option and this would also fall in line with the current smoking in pregnancy care pathway:
Smoking Status at the time of birth – would need to be verified with a CO reading which is generally felt to be inappropriate immediately following birth.
Smoking status at time of postnatal discharge from hospital – Deb is not keen on taking CO screenings at this time in case the appropriate action is not taken by the ward staff resulting in adverse outcomes for the baby.
Paul Seymour
Hi, Is anyone successfully collecting this at 12 & 16 weeks? If so, drop me a line as it seems there are various ways to do this, but if you have one that is proven, we'll go with that.
We ended up moving our smoking/co reading to transfer a while back as staff here also didn't like it in the Pre Delivery.
We used to offer patients a choice of a Smoking Cessation Referral at this point. Now we refer anyone with a high CO reading and/or are a Current smoker to our Stop Smoking Specialist Service irrespective of whether they want to give up smoking or not.
Question: Referring to Specialist Stop Smoking - As your Carbon Monoxide reading is high and/or you are a smoker we will be referring you to the Specialist Stop Smoking Service.
Answer: Yes
This is where the Stop Smoking referral is now generated automatically via secure email and sent to this 3rd party service and our own Stop Smoking Specialist Midwife becomes involved.
At Pennine Acute we have questions in the Pre-Delivery workflow. They are:
'Smoking at Time of Delivery?'
'What is the CO reading recorded at 36 weeks gestation?'
Did the woman smoke at 36 weeks? (please ask the woman)
Our SATOD data seems to be acceptable for our Smoking Midwife, however, she admits that our take up rate of recording/obtaining the CO reading at 36 wks is not good.
We are currently asking about the Risk Perception Intervention
Hi Deborah - can I ask how you record details of women who refuse help to quit. We get quite a few of these.
We still have Question 4 documenting where the woman does not give consent.
This is a good approach. We already have a 36 week question on our antenatal contacts to collect the CO reading. It still causes me some headaches though. When the midwife enters the gestation at time of contact as being 36 weeks, the question pops up to say "this is a 36 week contact - enter the CO reading.
First problem encountered, if the woman was being seen at 35 weeks for her 36 week contact then the midwife wasn't prompted so the woman wasn't screened. After discussion with senior midwives, I changed the criteria on Euroking so that the question would be asked at 35, 36 and 37 weeks.
Second problem, some midwives would then not screen because it wasn't 36 weeks exactly and would state in the CO reading box "not 36 weeks". We are working on this currently!
We have great success with the booking CO readings. When the woman accepts the stop smoking referral an e-referral goes directly to the Midwifery Health Trainers who then contact the woman to arrange to see her.
If the woman was smoking at time of booking, she is then asked at every subsequent contact if she is still smoking or has quit.
We altered our antenatal contacts on Euroking to provide a Risk Perception/Stop Smoking contact only. This has caused us workflow problems which I will have to address before too long. I think the idea of having the risk perception intervention questions added separately is great. I will be asking Alistair if anything prevents us from having the same format as I honestly wouldn't recommend trying to rework your normal antenatal contacts.
We ask the woman at Delivery Admission if she is smoking but we do not CO screen at that time. It was viewed by the midwives as being too intrusive.
Smoking in pregnancy is a massive issue in Blackpool - we lead the way nationally for all the wrong reasons!
I will be happy to report back to the group when we have done more work on this.
Hi
At TGH we have developed our own Smoking Cessation Referral within EuroKing and the Booking CO question pops up at Booking within the Current Pregnancy questionnaire and again 36 week CO question popping up in that Contact questionnaire and also at Delivery if this hasn't been collected at 36 weeks - this being the last entry for the reading to be collected. We have also added the antenatal Risk Perception Intervention Questions as attached.
Hope this is of some help
King regards
Deborah Goodyear
System Manager
Tameside and Glossop Integrated Care NHS Foundation Trust