
%0 Journal Article
%A Nicholl, Michael C 
%A Cattell, Miriam A 
%T Getting evidence into obstetric and midwifery practice: reducing perineal trauma
%J Australian Health Review
%D 2006/12/01
%V 30
%N 4
%P 462-467
%K 
%R https://doi.org/10.1071/AH060462
%U https://www.publish.csiro.au/paper/AH060462 
%X Problem: Frequent obstetric perineal morbidity in a hospital setting with service providers inexperienced in getting evidence into practice. Design: Clinical practice improvement methodology in a tertiary referral obstetric unit. Strategies for change: To cease active instruction to push in the second stage of labour; encourage the adoption of the left lateral position when delivering on a bed; use of the vacuum extractor rather than forceps where instrumental delivery indicated. Effects of change: Improved perineal outcomes with a 21.5% increase in intact perineum rate and a 100% reduction in fourth degree perineal tears. Lessons learned: Clinical practice improvement methodology is a useful tool for getting evidence into practice, resulting in improved clinical outcomes. 
