Background

 

The on-call anaesthetist is frequently contacted by midwives to troubleshoot epidurals. The resulting interventions required are usually simple, such as turning the patient laterally for topping up a one-sided block.

 In busy maternity units, delays in anaesthetic review may lead to prolonged maternal discomfort and a worse maternal experience.

 An epidural guideline to assist midwives in epidural troubleshooting existed on the hospital intranet. However, it was necessary to search through the trust-wide clinical guidelines to access it.

 It is also lengthy and text-heavy, limiting its accessibility and use.

 

Method

 

16 Midwives at Queen Charlotte's and Chelsea Hospital were surveyed using a 3 question yes/no questionnaire to assess awareness and usability of the existing

epidural guideline.

 A visually appealing, illustration-based poster titled "Epidural Troubleshooting" was developed focusing on common issues including unilateral block, inadequate analgesia, and suspected catheter dislodgement, and acted as a simple guide to rectifying the problem before calling the anaesthetist.

 The poster was displayed in all labour rooms and midwives were resurveyed after implementation.

 

Results

 

Sixteen midwives completed both surveys. Awareness of the guideline increased from ten (63%) pre-intervention to fifteen (94%) post-intervention.

 The number who reported having read the guideline increased from seven (44%) to fourteen (88%). Clarity improved from five (31%) to fourteen (88%).

 

Discussion

 

While comprehensive guidelines remain important, concise visual tools may be more effective for real-time clinical decision-making.

 This project demonstrates that targeted, accessible educational material can significantly improve staff awareness and perceived usability.

 This has the potential to reduce unnecessary anaesthetic referrals and improve maternal experience.

 

Key Message

 

Simple visual tools can translate lengthy guidelines into safer, faster, and more patient-centred care.