In the maternity stage, the main thing that is to be to keep in mind is the good quality service. If the service is not up to the mark then it can harm the women at the time of pregnancy. Thus, this study is based on an investigation which is conducted in the Homerton Hospital in terms of their maternity services. In order to provide a proper investigation, there will be a brief discussion of the company regarding their maternity services, tier background research, aims and objectives. In addition to that, there will be a literature review regarding the maternity service impacts and discussion about abnormal pregnancy. Moreover, there will be a methodology part, findings and analysis and in last conclusion and recommendation.
1.1 Background of the company
In the London Borough of Hackney, there is the Homerton hospital who is providing the maternity service for all the diverse local community around 252,000 women. In London, this area is denoted as the highest fertility rates. The hospital has around 500 beds spread in across 11 wards for the maternity services. In the hospital, there is more than 3500 staff. In the Homerton hospital, they offer both consultant-led care as well as midwifery-led for all the women in the maternity wards. Their main aim of the hospital is to inform all the women regarding their progress as well as if there is an issue or not. In the year 2015, in terms of deprivation, it includes that Hackney is the fifth most deprived local authority. In the year 2014, the hospital delivered around 5,842 babies. Moreover, there was information that from the 1st January 2015 to 30 September 2015 they delivered around 4,464 babies (homerton.nhs.uk 2017).
1.2 Background of the research
The services provided by the NHS hospitals are vital in respect of keeping the health quality of the residents of UK. It has been surfaced in different studies that the quality of maternity care service provides various NHS hospitals are questionable. In this regard, the identification of the definite points where the improvements are necessary requires being done. In such a scenario, the investigation into the service quality in NHS regarding maternity needs to be assessed. The rate of risky child delivery is increasing along with instances of mortality while giving birth. Hence, it is important to find out the issues responsible for this deterioration in service in terms of maternity care in various NHS hospitals.
The main aim of the study is to find out the main level of improvement for the maternal service in Homerton hospital.
To develop the criteria in term of evaluating the maternity quality service in Homerton hospital.
To understand the factors those can affect the maternity quality service in the Homerton hospital.
To assess the women those are pregnant regarding their attitude for the maternity quality service in the Homerton Hospital.
The main issue that is found at Homerton Hospital is their improper management because the customer has to wait for a long time in the queue to get their check up. In addition to that, there is another problem of cleanliness and infection control. The checklist of equipment is not properly maintained and there is a chance of improvement as well in the checklist.
The issue is constant at the Homerton Hospital because there is a lack of improper management. The cleanliness management is still not focusing on the proper cleaning in that area to make it hygiene for the pregnant women. Moreover, there has been a five maternal death in the year 2012 January and March 2015.
The issues are still going on because there was not put enough initiative in order to solve the problem. If there has been taken the closer look then it can be solved. Moreover, the research sheds lights on providing an immense idea regarding the quality of the maternity service which is provided in the Homerton Hospital. The research will also help to improve the quality of the maternity service which is provided to the women of the hospital.
1.6 Research question
In the overall research process, there is a requirement of some of the research questions that will have an impact on the research. The main research questions are as follows:
What are the factors those can contribute to the quality of the maternity service in Homerton hospital?
What is the process which is required for investigating the various aspects which are involved as well as has an impact on achieving the quality service of the maternal unit in the Homerton hospital?
Evaluating the effectiveness of the factors along with that their impact on the whole performance of the maternity quality service.
In this research, there is a detailed discussion of the objectives which can help for achieving the success of an organisation. The objectives are required to follow the SMART objective approach that makes an effectiveness of the entire research project. The research project will be conducted to achieving the organisation's goals and objectives. The research will provide an immense idea regarding the maternity service of the Homerton Hospital; the information will guide the future researcher. Moreover, the research will help to conduct the research on the specific time provided. The ideas can be obtained while conducting the research such as the quality factors and the amount of quality which is provided by the Homerton Hospital. The study will provide an idea regarding the maternity service and their quality as well.
2.0 Literature review
In the healthcare service in terms of maternal quality care, it provides care to more than 6000 women as well as their babies during the pregnancy time. There is a discussion of the factors those are contributing in the midwifery as well as the impact of abnormal pregnancy and the investigation of the maternity also.
2.2 Factors contributing the quality service of maternal unit in midwifery
At the time of woman's pregnancy, after birth and labour, midwife multi-disciplinary team, maternity support workers, Obstetricians, GPs, neonatal as well as neonatologists all of them will take care of the baby and their mother also. In most of the women in their uncomplicated pregnancies time, there is antenatal care provided to them by the local community midwife team. In the opinion of Okatch, Afrane & Nyaguara (2016), at the time of pregnancy, there is a requirement of providing the good quality maternity service to all the women. The main reason for providing a good quality maternity service from the hospital is because the women put their lives and the baby lives upon the trust of the healthcare professionals. Moreover, there is a regular appointment will be done for their check up wit midwife in the obstetrician or GPs.
The women those are coming to a more complicated situation can be seen most of the time in the antenatal clinic by the obstetricians sometimes or it can be all the time. As per the view of Phillimore (2015), the complicated pregnancies are required to provide extra care because there is a chance danger at the time of pregnancy. The community antenatal care is working together with the GPs in terms of providing the appointment to the mother for their care. In addition to that, there is seven community midwife team located in Hackney. Moreover, there are regular antenatal clinics present in the local GP surgeries, children centre as well as on the health centre.
2.3 Impact of abnormal pregnancy
Most of the pregnancies are healthy and normal but sometimes there can be seen some of the symptoms of abnormal pregnancy. The abnormal pregnancy is mainly when there occur some kind of complications, chromosomal and congenital abnormalities and various others complications. In the opinion of Dietz, Pardey & Murray (2015), the women those are having complications at the time of pregnancy are required to put them in the centre of attraction and give extra care as well because it can harm their babies. In the abnormal pregnancy case, there are various ranges of service offered in the healthcare setting such as invasive (diagnostics) and non-invasive (screening). These two procedures help them to identify any type of problem at the time of pregnancy. The major impact of abnormal pregnancies is upon the emotions of the parents. The emotions of both the parents are hurt after the abnormal pregnancies.
The abnormal pregnancy has a huge effect on both parents. In most of the places at the time of abnormal pregnancy, there are various stages such as ultrasound scanning that includes the anomaly scanning, fetal well being, growth scans, and Doppler ultrasound. In the invasive procedures, it includes the sickle cells, cystic fibrosis muscular dystrophy as well as the chromosomal abnormality. In addition to that, if there is the high risk of pregnancy then it includes the more dope fatal, uterine and biophysical profile. As opined by Higginbottom et al. (2014), the screening test is much common in the pregnancy because it does not carry any type of risk. The common screening test is performed while including the combined test for 11 to 15 weeks with a detailed anomaly scanning around 20 to 24 weeks as well as the Doppler ultrasound is done for 20 weeks.
2.4 Investigation of maternity and gynecology unit
In the maternity as well as gynecology unit there is a requirement of investigation which shows the investigations that can be helpful for making an improvement in the pregnancy stage. In the Homerton Hospital of NHS foundation, the trusted quality of the service report has been shown that there is an improvement on the safe as well as on the services of in terms of taken care of the pregnant women. In the view of Johnson et al. (2016), from the investigation, if there is any source which can be important when it is required to improve them for the betterment of pregnant women. Thus, it is found that the cleanliness of unit hygiene has been improved to a great level. In 2013 to 2014 there were two serious incidents occur of maternal death as well as on January 2015 there was also maternal death.
The main reason for this investigation is to enforce the power in terms of serving three notices so that they can improve their care services provided to the pregnant women. Moreover, in the investigation process, there was the involvement of governmental bodies as well for monitoring the maternity service to the pregnant women. In addition to that, there was the involvement of the staff in improving the maternity quality service of the hospital. There is also a space for improving the governing structure as well as the reporting system for conducting a proper investigation unit.
In terms of maternal death, there was found that in the year 2012 January to 2015 December there was around five maternal death which highly affected the emotions of parents. The main reason for maternal death is because of the improper management. As opined by Cherguit et al. (2013), in the healthcare setting there is a requirement for proper management as well as clean areas for the barrens of the patient. Thus, it is found that there is an improvement in the hospital in terms of cleaning as well as it is dust free also. There is also an effective working for transferring of the newborn baby to the neonatal emergency unit. The investigation also makes sure that there is a 24-hour member service for tackling any kind of emergency situation.
In this part, it is found at the time of pregnancy there it is the delicate situation and the environment is required to be clean and hygiene for both the mother and baby. In the abnormal pregnancy case, the most affected are the parents. The investigation also found that there is a scope for improvement, on the other hand, there are has been done some improvement.
In the methodology section, there was the selection of both primary as well as the secondary research method. The methodology part provides a clear idea regarding the techniques and methods for finding the relevant results. In this part, there is both qualitative, quantitative and statistical from are shown.
3.2 Primary research method
The primary research method is relevant and provides a clear view regarding results of the topic. Moreover, the primary research is of much high accurate. The primary data can be collected through various medium such as telephone, survey, focus group and so on. In the view of Amato & Portaccio (2015), the primary data are original, in nature.
This research method is selected because it will provide accurate data and there will be no kind of falsehood. The primary data can be collected from various of ways.
3.3 Secondary research method
The secondary research method is mainly used for gaining an insight idea of the topic. In the view of Deveneau et al. (2014), secondary data is classified into two groups they are internal and external. The secondary research is the common form of research and it is used with the help of primary research.
The secondary research will be selected because it provides the result much faster. In addition to that, it also provides the result at a low cost. The secondary research also provides a frame that in which direction the research is going to take place.
3.4 Data collection method
In the qualitative research method, the interview provides a clear idea in terms of finding the result. The interview can be conducted in various of ways such as face to face interview and telephone interview.
The interview has been selected because it can show the direct result at the time of interview. The interview also saves time as well.
Face to face interview
The face to face interview is a type of interview. As per Triunfo & Lanzone (2014), the face to face interview also provides a high response to the survey research.
The main reason behind the selection of face to face interview is that it helps to clarify the answer as well as it is relevant. In the face to face interview most of the time there is an active participation.
The telephone interview is less consuming as well as less expensive. In the opinion of Hartling et al. (2014), the research can be done on the people those are having the telephone.
The telephone interview is selected because it is less expensive and can get a huge amount of people those are having the telephone.
The web-based question is conducted through the medium of email as well as a secure website those are filled with lots of questions. As commented by Liao et al. (2014), the web-based question is much faster and there is not more detailed information.
This method will be selected because it does not consume much time and it is growing to a large extent.
The paper-based question can be provided to a huge number of people. As stated by Hawkins et al. (2013), this method saves a lot of time and money well for conducting the research.
This method will be selected because it provides relevant results and people are more truths because their identity will not be disclosed.
The observations mostly take place in the natural setting as well as when there are lots of descriptive and lengthy notes regarding the research area. The observation helps to provide an idea regarding the behaviors of people while giving an interview. The observation can provide insight information of the research
The focus group is used for gathering the information. The group interview can be used when there is a limited resource.
3.5 Gantt chart
3.6 Research instruments
The sampling method is generally a procedure for selecting a group of members from the population. As per Hacker et al. (2015), there are three types of sampling method such as simple random sampling, cluster sampling and stratified sampling.
In this report there is the selection of simple random sampling technique there will be a sample size of 100 points.
3.7 Ethical issues
In order to accomplish the concerned research study, proper ethical considerations have been considered. The information and data from the proposed sample will not be gathered unethically. All the data and information have been gathered solely with de permission of the participants. The gathered data and information from the sample will be used for the sole academic purpose strictly.
In addition to that, the gathered information and data from the primary sources will not be distorted or misreported. On the other hand, the concerned data and information from the primary sources will be considered under the data protection act, which stated that all the data and information will be kept secure and safe. No information gathered from the participants will be disclosed. Moreover, the identity of participants will not be revealed or disclosed under the Data Protection Act, 1998.
3.8 Data analysis and interpretation
The data analysis is going to include the common patterns as well as critically analysis for the achieving the research objectives and aims. There is the qualitative research analysis which includes the interview, focus group etc. the quantitative data analysis includes the interpretation of figures as well as the critical analysis for finding the relevant result.
4.1 Findings and analysis
In this chapter, there is the result of the primary data which is collected from the surveys and questionnaire. The result those are present are all relevant and it is collected from a significant source.
4.2 Limitation of the research
In any research, there are some limitations which create the problem in terms of completing the research project. The main limitation of the research is time because there is very limited time present as well as financial is also a limitation. There is some company those refused to provide the information and there is the shortage of finding the information.
5.0 Conclusion and recommendation
From the above study, it is found that in pregnancy is a very crucial stage and there is a requirement of proper maternity service that can be helpful for providing the appropriate care. If there is any kind of abnormal pregnancy then the most affected people is both the parents. There is an emotional hurt occurs at that time. There is the selection of both primary and quantitative method for finding out the relevant result of the investigation. In the hospital, there is a requirement to have a clean area and proper management and provide the emergency case in the first preference.
There is the recommendation of providing the proper care for the women those are pregnant. There is a requirement of 24-hour availability of the service for any kind of emergency case. The procedures are required to be simpler and it is recommended to have a proper management in the hospital. It is recommended to train their staffs more properly and make an improvement on the equipment those are required to check at the time of providing maternity services. The staff in the hospital is recommended to be friendly and cooperative as well as provide an equal care to each and every person.
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