Community PROMPT Wales5

Community Midwives in training

FAQs

What does a PROMPT Wales training day consist of?

PROMPT Wales is a full day training course, attended and facilitated by a multiprofessional maternity team. The emphasis is on team working, communication and the impact of human factors, as well as clinical management. Delegates are allocated to multiprofessional teams to take part in simulated obstetric emergencies in their own clinical setting. Some examples would be attending an undiagnosed breech birth in a midwife-led unit or managing a cardiac arrest. Community midwifery teams attend Community PROMPT Wales training where they train alongside paramedics and practise managing childbirth emergencies in a community setting.

What is the overall objective of the PROMPT Wales programme?

PROMPT Wales is ‘more than just training,’ it is about what happens every day in clinical practice. Training brings the team together, helping to build respectful working relationships where every member of the team feels valued and safe to voice an opinion. PROMPT Wales training has encouraged the embedding of algorithms and proformas in to every day practice in NHS Wales, making ‘the right way the easy way.’ And of course, the overall objective of PROMPT Wales training is about enhancing the clinical management of an obstetric emergency though improvements in teamworking, communication and the use of tools and algorithms, leading to safer maternity care and outcomes.

How will we know that PROMPT Wales training is effective?

As demonstrated in Southmead Hospital in Bristol and other maternity units in the UK and abroad, we expect to see improvements in outcomes here in Wales.

We have demonstrated improvements in staff perception of team working and safety, measured using a validated Safety Attitude Questionnaire. Results from pre and post implementation of PROMPT Wales shows improvement in all six domains: teamwork, safety climate, perception of management, job satisfaction, working conditions and stress recognition.

PROMPT Wales has also been effective at bringing teams together to train and reducing variation in the provision and quality of training. In 2017, there was little in the way of multiprofessional training in NHS Wales maternity services, with the different professions receiving varied training, and this differed between the obstetric units in Wales. Our process measures demonstrate that PROMPT Wales training is standardised across Wales; facilitated by midwives, obstetricians, and anaesthetists; and attended by the whole multiprofessional team. Overall attendance for 2022-23 was 90% of all maternity staff in NHS Wales.

PROMPT is associated with a reduction in low 5-minute Apgar scores and HIE (Draycott et al, 2005). NHS Wales has seen a reduction in term and preterm APGAR score of less than 7 at 5 minutes since the implementation of PROMPT Wales.

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