Guidelines exist to ensure consistency in the delivery of care to minimise health-related complications. Even when good evidence is available, professionals do not necessarily implement it resulting in an evidence-practice gap. Guidelines for the management of maternal obesity exist, however a 2011 study at our tertiary maternity hospital demonstrated varied staff knowledge of, and attitudes and adherence to these guidelines. We subsequently followed an implementation science approach to facilitate the translation of these guidelines into practice to ensure best practice delivery of care to pregnant women regarding gestational weight gain (GWG). The aim of this study was to re-assess staff knowledge, attitudes and behaviours around the management of GWG in our hospital following these service changes.
This cross-sectional, prospective online survey was distributed to staff in antenatal clinic. The survey assessed staff awareness of pregnancy-related weight complications, knowledge and application of specific guidelines, and a guideline adherence score was calculated.
Sixty-nine staff (44.8% response rate) completed the survey. Just over half (51.9%) stated they were familiar with clinical guidelines regarding weight management in pregnancy. Guideline adherence ranged from 3.7 ± 1.9 to 11.3 ± 1.0 /15 across different professional groups; significant improvements with adherence by dietitians were noted over time. Despite minimal change over time in the overall adherence score, compliance with individual elements of the guideline recommendations comprising the adherence score differed. Improvements in staff practices and attitudes are apparent since the first survey.
The delivery of evidence-based care is an iterative process of monitoring and improvement. This study has highlighted further improvements in guideline awareness and guideline elements are still required to improve the delivery of best practice antenatal GWG care.