Saving-Babies-Lives-Care-Bundle-Version-Two-Updated-Final-Version

Saving Babies’ Lives Version TwoA care bundle for reducing perinatal mortality... Reducing preterm birth This is an additional element to the care bundle developed in response to The De

Reducing smoking in pregnancy

Reducing smoking in pregnancy by assessing exposure to carbon monoxide (CO) as appropriate to assist in identifying smokers (or those exposed to CO through other sources) and refer them for support from a trained stop smoking advisor Interventions

1.1 CO testing should be offered to all pregnant women at the antenatal booking appointment, with the outcome recorded

1.2 Additional CO testing should be offered to pregnant women as appropriate throughout pregnancy, with the outcome recorded

1.3 CO testing should be offered to all pregnant women at the 36 week antenatal appointment, with the outcome recorded

1.4 Referral for those with elevated levels (4ppm or above) for support from a trained stop smoking specialist, based on an opt-out system Referral pathway must include feedback and follow up processes

1.5 All relevant maternity staff should receive training on the use of the CO monitor and having a brief and meaningful conversation with women about smoking (Very Brief Advice - VBA)

1.6 Maternity care providers must examine their outcomes in relation to the interventions and trends and themes within their own incidents where smoking in pregnancy is felt to have been a contributory factor

1.7 Individual Trusts must examine their outcomes in relation to similar Trusts to understand variation and inform potential improvements

1.8 Maternity providers are encouraged to focus improvement in the following areas: a Effective identification of women who smoke during their pregnancies b Increase the provision of effective training of staff in relation to smoking during pregnancy c Working with local partners to develop effective pathways of care for referral for specialist stop smoking advice

Process indicators Outcome indicators i Recording of CO reading for each pregnant woman on Maternity Information System

(MIS) and inclusion of these data in the providers’ Maternity Services Data Set

(MSDS) submission to NHS Digital ii Percentage of women where CO measurement at booking is recorded iii Percentage of women where CO measurement at 36 weeks is recorded i Percentage of women with a CO measurement ≥4ppm at booking ii Percentage of women with a CO measurement ≥4ppm at 36 weeks iii Percentage of women who have a CO level ≥4ppm at booking and