Perioperative groups have issued a statement calling for safe staffing levels in obstetric theatres, following the results of recent studies into obstetric resources.
The surveys prompting the call for action show that on-site dedicated anaesthetic assistance for Caesarean deliveries is only available in 42% of cases and that the midwife is asked to take the role of the scrub assistant in addition to midwifery duties in around 60% of deliveries. Diane Gilmour, President of AfPP (the Association for Perioperative Practice), commented: “The safety of mother and child is the primary duty of all those involved in Caesarean deliveries. These recommendations highlight areas for improvement where the risk to both can be significantly reduced. Strategic Health Authorities need to act now to ensure that these recommendations are made reality for all obstetric procedures. “The key fact is that staffing is not adequate in all obstetric procedures. News reports of a shortage of midwives and reduction in junior doctors’ hours prompted our survey and the results confirmed that there are significant issues in obstetrics. Health Authorities need to be aware that they cannot cut corners when dealing with Caesarean deliveries.” The consensus statement describes the statistics as being of “significant concern” and highlights the seventh Annual Report of the Confidential Enquiry into Stillbirths and Deaths in Infancy (CESDI) which cites 11 occasions of anaesthetic-related deaths in obstetrics of which four were attributed to the absence of a skilled anaesthetic assistant. Among its key recommendations, the statement calls for: • Trained perioperative personnel to replace midwifery staff in the scrub assistant/assistant role completely by 2012. • All obstetric units to have a dedicated out-ofhours anaesthetic assistant available on site. • To minimise the risk of complications the scrub/assistant role for all emergency Caesarean sections must be assumed by a Registered Nurse or Operating Department Practitioner.
