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  • Publication
    The impact of COVID-19 on attendance for reduced fetal movements during pregnancy
    Background: The World Health Organisation (WHO) declared a global pandemic on the 11th of March 2020. The Irish government subsequently imposed the first national lockdown and stringent measures to curb the spread of COVID-19 between March-May 2020. Concerns were raised about whether women were fearful of accessing maternity services during the lockdown. Maternal perception of reduced fetal movements (RFM) in pregnancy is a common reason for self-referral to maternity services. International guidelines recommend that women perceiving RFM attend their maternity unit for fetal assessment. Objectives: We sought to determine the impact of the first global pandemic lock-down on attendances for reduced fetal movements (RFM) during pregnancy in a large urban maternity unit. Methods: All women with a singleton pregnancy, presenting to the emergency department (ED) of the National Maternity Hospital, Dublin with a primary presentation of perceived reduced fetal movements after 24 weeks’ gestation between 1st January 2020 and 30th April 2020 were included. Findings: Between January 1 and February 29, 2020 there were 2135 total attendances to the ED; 264 of these were for RFM (12.4%). From March 1- April 30, we observed a significant decline in the number of attendances to ED, totalling 1458; 231 of these were for RFM (15.8%). During the first lock-down period (March-April 2020) overall attendances to the ED decreased by 31.7%, however referrals for RFM increased by 27.4%. Conclusions: There was a significant decrease in the number of attendances to the ED during the first lockdown of the COVID-19 pandemic, however referrals for RFM increased.
  • Publication
    Evaluation of a national training programme to support engagement in mental health services: Learning enablers and learning gains
    INTRODUCTION: The Irish national mental health service provider commissioned a national training programme to support a patient and public involvement (PPI) initiative in mental health services. The programme evaluation afforded an opportunity to describe the learning gains and learning enablers and the factors that support PPI in mental health. AIM: We aimed to evaluate a PPI training programme across nine regional administrative units in a national mental health service. METHODS: We conducted a participant exit survey, using the Student Assessment of Learning Gains (SALG) instrument. We analysed the survey responses using SPSS version 24 software and applied directed content analysis to the narrative comments provided in open-ended questions. RESULTS: A total of 54 participants returned the completed questionnaire, yielding a response rate of 60 per cent. The overall mean SALG score yielded was 3.97 (SD 0.66; range 1-5), indicating that participants reported very good to excellent gains in their learning from the programme. Participants who offered narrative comments indicated an overall positive experience but suggested that all stakeholders should work together to co-produce the training. DISCUSSION: All the stakeholders in a PPI training initiative to support the engagement of service users, their families and carers in mental health, should work together to achieve their desired outcome. This requires co-production in the design, delivery and evaluation of the training initiative, and co-production can impact at both individual and local levels. IMPLICATIONS FOR PRACTICE: PPI training initiatives in mental health should retain a focus on understanding conflict resolution, committee effectiveness, interpersonal and facilitation skills. Ensuring a shared understanding of key concepts, such as co-production, is a necessary prerequisite at the co-commissioning, co-design, co-planning, co-delivery and co-assessment stages of programme development As is the need to avoid artificial or actual distinctions between health professionals and those who are non-professionals, such as the service users.
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