K2 INFANT-Guardian® Puts an Expert at the Bedside in Every Delivery Room
Guardian replaces all paper notes within the delivery room. All clinical information is captured at the bedside, electronically.
This system embeds CTG guidelines for structured reviews, in line with national guidelines.
Maternal observations are automatically calculated as a MOEWS score and charted to facilitate the early warning of potential problems.
For both low risk, and for high risk labours, Guardian will capture the full electronic partogram contemporaneously and at the point of care. The layout of the partogram is customisable and presented in a way that clinicians will find familiar. It details the results of examinations, auscultation, anaesthesia and analgesia, drugs and fluids, maternal observations, contractions and administration of oxytocin. This information is then communicated, over the regular hospital computer network, where it can be viewed at central stations, doctors’ offices and consultants’ homes, if on call.
The many for one care model means that senior staff always have oversight. They no longer need to wait to be asked for an opinion, which carries the risk of something being missed and therefore no-one being called. Instead, senior staff are aware of what is going on and they can make an intervention when they feel appropriate. This is a fully supported model of care and is inherently far safer than an over-reliance on individual care givers.
Guardian is specifically designed to facilitate clinical teamwork, incorporate safety strategies, such as ‘Fresh Eyes’ and embodies hospital and national clinical guidelines. This system informs ward rounds and provides the means for effective staff shift handovers, ensuring that important information is properly relayed and not forgotten or overlooked.
Guardian incorporates an intelligent electronic chalkboard, which is called the SaFERR Births Board. SaFERR stands for “Situation & Features, Evaluation, Risks & Requirements” and presents the dynamic, real-time update of care for all women on labour ward. Importantly, all information presented of the the SaFERR Births Board has been automatically transmitted from each of the bedside clinical notes. As well as communicating the situation and features of each labour, it also presents a specific patient’s risks and future care planning information. We believe that the SaFERR Births Board, in its own right, represents a major risk reduction technology.
Guardian is a comprehensive risk reduction technology for labour and delivery. It brings hospital and national guidelines and care bundles to the very point of care, to ensure that care is consistent with best practice to reduce errors.
Guardian is an intelligent system that ensures the capture of quality data, replaces paper and cuts out duplication of record keeping. All data captured is complete and accurate.
Guardian is the clinical record. This makes reporting and governance, maternity dataset returns, payment by results and obtaining babies’ numbers easy and reliable.
Guardian is designed to change and improve the environment in which clinicians work, to reduce the risk of human errors being transmitted to patient care, where they could then cause avoidable poor outcome.
Guardian is a communicator and facilitates a structured teamwork approach to care, with appropriate senior staff oversight and has been designed to mitigate risk and reduce human errors.
Guardian is a technology to improve care for mothers and their babies.
Returning to our comparison of monitoring approaches, we see that Guardian will capture a continuous electronic recording of fetal heart rate, as well as auscultation for low risk women. But, with Guardian, the monitoring is now near-continuous, with senior staff oversight throughout the hospital and remotely.
The model of care is transformed to many-for-one and there is at least an intermittent level of monitoring, when the clinician is out of the birth room.
The interpreter’s level of skill is improved by virtue of many pairs of eyes overseeing the monitoring, which will lead to an interpretation that is consistent.
There are more learning opportunities with Guardian, because there is more senior staff team-working and interaction.
The combined features of Guardian come together to reduce the risk of an incorrect or missed interpretation. Guardian reduces the risk of human error.
REMEMBER: In relation to human errors, during labour, there are two problems:
Problem number one was that the model of care was fundamentally flawed, with an over reliance on individual members of staff that sets up a single point of failure. Guardian addresses this problem.
Problem number two was that CTG interpretation is hard. Not everyone can do it well, even with training. It is not possible to have sufficient expertise present at every bedside, day and night.
Our response to problem two, was to develop INFANT. INFANT is fully explained in our third infographic, “Computerised Interpretation of Fetal Monitoring, During Labour“.
INFANT and Guardian have been subjected to the largest maternity technology evaluation ever undertaken by the UK’s National Health Service. The INFANT Study is detailed in our fourth infographic, “The INFANT Study – A Multi-centre, Randomised, Controlled Trial of 47,000 Births”