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Focus on: A Midwife’s role with Flo

Anne Webb – Midwife 

Anne Webb is a Midwife at Great Western Hospitals NHS Foundation Trust.  Anne has kindly taken some time to share with us her experiences of working with Flo as a clinician, for our new “Focus on Evaluation Project”.

What is your background and role within your organisation?

“I work in the Day Assessment Unit (DAU)/Antenatal Clinic as a midwife caring for women with raised blood pressure/symptoms of pre-eclampsia.”

What did you set out to achieve with Flo and how did you go about it?

“Our aim in offering Flo was to be able to provide our pregnant mums with the opportunity to safely take their own blood pressure readings at home, saving them from needing to attend the DAU for routine blood pressure check appointments.  We envisaged that this would have a significant impact, especially to those ladies prescribed medications that required twice weekly appointments.  When checking their blood pressure at home, ladies are more likely to be relaxed and record an accurate blood pressure reading.  This avoids the implications of either white coat hypertension, or raised blood pressure as a result of environmental factors associated with their journey or visit to the clinic.

Being able to send their blood pressure readings via Flo saves on childcare, parking costs, and ladies having to take time off work. Also, we all like using our phones, so it is easy to send their readings in to Flo.
Ladies are only prompted by Flo on Fridays to send their reading in.  We also have an antenatal clinic on a Friday specifically for blood pressure, so it’s easy to identify ladies for Flo.”

Were there any surprises?

“Flo is a different way of having an appointment; some colleagues have not been keen to change their way of working and are not always comfortable with having women take responsibility of looking after themselves.

However, most women record better readings for their blood pressure when taken at home, compared to clinic readings.  They also like the freedom of being able to do it at home with Flo, but they know they can phone if they have any problems.”

How do your patients feel about Flo?

“On our post trial survey, 100% of women would recommend Flo to their friends and are happy to be involved.  Ladies also check their blood pressure on other days (rather than just Friday when they are prompted to), as they have a machine at home to do it, and will phone the DAU if their readings are high.  This indicates an improved understanding of the implications of their blood pressure and provides an opportunity to intervene earlier with a change in treatment if required.

Gaining feedback has also been easier – as our ladies are already interacting with Flo, they are more likely to respond.”

What can you do more/less/differently with Flo?

“We will hopefully continue with Flo on a Friday as it appears to be successful.  Integrating Flo into our pathway has picked up ladies who are developing PET (pre-eclamptic toxaemia)/rising BP, where before they may not have sought medical help, or just waited to see their community midwife before getting reviewed.

We still review the ladies’ readings, even though Flo will ask them to phone the DAU if there are any concerns.  Sometimes the readings are borderline normal, so we use Flo to send our ladies a message to ask them to repeat their BP/retest urine sample.”

What are your future plans with Flo?

“We are going to use Flo with Elecys (a blood test to determine if a woman is at risk of developing pre-eclampsia); if the blood results are borderline, the ladies will then use Flo to monitor their BP/urine.”

#Blood Pressure #Great Western Hospitals NHS Foundation Trust #Pregnancy #Maternity #TotallyUnique

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