Maternity Services Waterford Regional Hospital

Profile of the Maternity Department

WRH's maternity service is a busy and progressive unit providing obstetric, midwifery led, gynaecological and neo natal intensive care services. The service employs sixty-five midwives, three consultant obstetricians/gynaecologists, and nine non-consultant hospital doctors and three paediatricians. There are two clinical midwife specialists in ultrasound. The birth rate in 2005 was two thousand three hundred and forty two. The maternity services at Waterford Regional Hospital has a well established Integrated Hospital Community Midwifery Led Service (IHCMS) which delivered two hundred and nine women and nine home births in 2005. The neonatal service provides four intensive care beds, ten special care and ten step down beds. 

Midwife Led Services

 A team of four midwives provide Integrated Hospital and Community Midwifery service for women with low risk or no risk pregnancies in the hospital or home setting who fit specific criteria agreed by an interdisciplinary team in line with best evidence available.

A midwife led antenatal clinic provides care in the antenatal outpatients along with consultant led antenatal clinics.

A midwife led outreach clinic provides care for eighty low risk antenatal women per year in Dungarvan.

The Early Pregnancy Unit established in 2003 is midwife led and in 2005 saw two thousand five hundred and seventy seven women including return visits.

Care by Midwives was provided under the direction of consultant led guidelines, policies and protocols until 2002. Midwife led guidelines were introduced in 2002 and are currently under review by the Regional Guidelines Committee (review completion date September, 2006).

Clinical Midwifery Specialist (CMS)

In 2000, one clinical midwifery specialist (CMS) role was developed in Ultrasonography at WRH. The CMS works closely with mothers and partners and the multidisciplinary team enhancing the service offered to pregnant women. A similar CMS post has been developed and appointed in the Early Pregnancy Unit.

Integrated Hospital Community Midwifery Led Service (IHCMS)

The demand for home births and Domino Care by pregnant women in the Waterford region could not to be met by hospital based midwives, Public Health Nurses and Independent Midwives. A formal system for Integrated Hospital Community and Midwifery Led Service was planned and established in 2001. The ethos and philosophy of this service was the development of midwifery led care for women with low risk or no risk pregnancies in the hospital or home setting who fit specific criteria agreed by an interdisciplinary team in line with best evidence available. Four midwives (including the team leader) deliver the service. An evaluation of the service was carried out in 2001 and 2004. This evaluation has played a major part in the decision to focus development on the role of an AMP in Waterford and is guiding professional development priorities in 2006/2007.

Baby Friendly Hospital Initiative (BFHI) - National Award

This award of quality achievement was presented to Waterford Regional Hospital in 2004. Waterford Regional was the second hospital in Southern Ireland to gain this award (excellence in breastfeeding practice). A bronze award for work place breastfeeding practices was awarded in 2004. 

Pre Registration BSc Midwifery Programme

Maternity Services Waterford Regional Hospital in collaboration with the University of Limerick and the Mid Western Regional Maternity Unit in Limerick are in the process of identifying and discussing the supports and resources required to support the midwifery students in the clinical environment when they commence their clinical placements in Waterford in Proposed AMP at Waterford Regional Hospital, Maternity Unit

The site preparation and job description was completed and is ready for submission in 2006 to the National Council for Professional Development of Nurses and Midwives.

Hospital Accreditation Process

WRH is participating in the Irish Society Hospital Accreditation Board (ISHAB) process and achieved the Pre Accreditation Award Level 1 in autumn 2005. A number of areas of excellences were identified within the maternity services:

Clinical Areas

Maternity Outpatients

Maternity outpatients consist of nine examination rooms; two are allocated for fetal ultrasound. Dedicated urodynamics and colposcopy services operate from the clinic.

Antenatal /Gynaecological ward

This ward consists of thirty-five beds, twenty-one antenatal beds and thirteen gynaecological beds. A Bereavement Room is used by both the maternity and neonatal services and an allocated Family Room was established in 2003 and is exclusively used for families experiencing loss in pregnancy, childbirth or the postnatal period. 

Early Pregnancy Unit

 The Early Pregnancy unit consists of an office and treatment room.

Integrated Hospital Community Midwife Service

The team leader has an office and dedicated antenatal outpatient consultant rooms.

Delivery Suite

The delivery suite consists of one admission room, one first stage room with three beds, four delivery rooms, and one obstetric theatre with an adjoining recovery room.

Postnatal Ward

The Postnatal Area has twenty-four beds and a large parent craft room. It also incorporates a Breastfeeding/Express Room for working staff and visiting mothers to the hospital. 

Parent craft Education Room

A large Parent Craft Education Room is situated in the Physiotherapy Department.

Staff Profile

Midwives

Waterford Regional Hospital employs sixty-five whole time equivalent Midwives (WTE) to provide its maternity service for the women and their families in the region. This includes one Assistant Director of Nursing/Midwifery, one CMM III, four CMM II's, two CMS's, and four CMM I's.

Medical Team

There are three Consultant Obstetricians/Gynaecologists, five registrars, and four senior house doctors in the maternity department. 

Health Care Assistants

Six Health Care Assistants support the maternity services in Waterford Regional Hospital.

Clerical Staff

Four secretaries and four ward clerks provide the secretarial service for the Maternity department.

Hospital Social Worker

Waterford Regional Hospital has one Hospital Social Worker dedicated to its service.

Physiotherapy

Waterford Regional Hospital has one Obstetric /Gynaecological Physiotherapist supporting the Maternity Department.

Number of deliveries per year: 2342

Antenatal ward, number of beds; 35 and midwives: 20 WTE

Number of Midwife patient ratio:

Postnatal ward, number of beds: 24

and midwives: 14 WTE

Number of Midwife patient ratio:

3. Working hours

Shift times

8am to 8 pm8 am to 3 pm Night duty 1 week in 5 generally . All rosters are planned in advance and requests are

Education opportunities

Continuing professional development.

All midwifery managers keep a record of educational programmes under taken by the staff. The Nursing Midwifery Planning and Development Unit co-ordinates sessions in the following:

 18-hour breastfeeding course.

 Fetal monitoring.

 Intravenous Cannulation training days.

 Perineal suturing sessions.

 ALSO courses

 Documentation workshops.

The Nurse Practice Development Office WRH is currently running a number of one-day education sessions including the following topics for all staff:

 Sharps training

 Fire training

 Infection control

 Haemoviligance

 Clinical risk

 Documentation

 Medication management.

The Nurse Practice Unit also delivers a yearly Professional Develop day for the nurse and midwife managers.

Clinical risk management programmes

 Education sessions on clinical risk management are included in the yearly professional develop day for the nurse and midwife managers I, II and III.

 The Nurse Practice Development Office WRH is currently running a number of one day education sessions for all staff and clinical risk is included in the course content of the day.

Midwifery Project Officer

The project officer facilitates service development and ongoing continuous professional development. Arising are the following:

 A Midwifery Management development programme for all midwife managers.

 Leading Empowered Organizations (LEO) leadership programme for midwifery managers.

 Yearly conference on normal midwifery practices.

 Development of a yearly professional development prospectus.

 Regional intravenous cannulation study days.

 Perineal suturing programmes. In-house instructors facilitating education and supervision of other staff midwives.

Documentation audit leading to the pilot introduction of new patient case notes since May 2006. Documentation workshops facilitated by in house staff twice monthly.

Once weekly a midwife facilitator provides in-house workshops for advanced life support in obstetrics (ALSO) drills for staff (midwifery and medical).

 Twice monthly a midwife facilitator provides in-house neonatal resuscitation drills for staff (midwifery and medical). 

Interdisciplinary orientation programme provided each January and June for new staff joining the service.

Cardiotogograph (CTG) workshops facilitated by a midwife once weekly.

Accommodation

Ardkeen Woods , Apartements situated 5 minutes walk from the hospital

Other useful information

A bus service operates every 30 minutes from outside the hospital to Waterford City which is 10 minutes drive from the hospital .

Waterford is a port city and surrounded by beautiful sea side resorts all within 30 minutes drive of the hospital .