RESTORATIVE BENEFITS WITH SENSORY DELIVERY · PDF fileFrom the patient questionnaire on...

RESTORATIVE BENEFITS WITH WAVECARE SENSORY DELIVERY ROOM

The study from North Zealand Hospital, Denmark is based on 102 patients, 4 staff in qualitative and quantitative interviews, conducted by MSA, Annemette Lundmark.

Other information, inside this paper is conducted by M. Sc. Laura LaCava from the white paper : Ambient Interventions in Healthcare.

The study

The purpose of this paper is to provide healthcare professionals an introduction to research on the efficacy of the Wavecare Sensory Delivery Rooms, summarized from two studies, conducted by

Lundmark, 2014 and LaCava 2014.

Site of Origen

Stress and anxiety can stop a labor procedure. The main purpose by using light, music and imagery in this setting, is to create an

overall secure stress-reducing ambience around the woman in labor and create a tool to support the professional integrity from the midwife, investigate and show evidence. The two sensory delivery rooms inside this study has now been

used for more than two years, and show no deviation from the study, except smaller practical issues with the hardware, which has now been improved. Two ongoing science projects are currently investigating parameters, indicated from the study.

MSA, Annemette Lundmark, 2014 / M. Sc. Laura LaCava, 2014

Method

The first sensory delivery room mockup is created from the experience and science with ambient interventions in general, and designed in close cooperation with a group of midwifes

inside a PPI project organized by North Zealand Hospital and the Danish Government. The Sensory Delivery Room is designed to have a simple user interface, allowing midwife or staff to operate the intervention

even with simple knowledge about the technical functions, and still having a large impact of the ambience inside the sensory delivery room.

Project Group

The study was conducted from August 28, 2013 to January 1 2014, by MSA, Annemette Lundmark.

Control group, North Zealand Hospital:

Executive Midwife, Katrine Hornum-Stenz Assistance Executive Midwife, Dorte Dahl Midwife, Gitte Ulriksen Head of Innovation and Science, Irene Haagensen

Four project midwifes was picked and trained from the beginning to operate the Sensory Delivery Room´s inside the study.

MSA, Annemette Lundmark, 2014 / M. Sc. Laura LaCava, 2014 Page �2


What is Ambient Interventions in general

Ambient interventions, that is, the incorporation of light, music, sound, color, nature and nature images in hospital design has become a preoccupation of healthcare professionals around

the world. Research in various fields including environmental psychology and the practice of evidence based design, support the use of these interventions as part of the profile of hospitals and to support medical procedures, where the reduction of

stress can effect the pharmaceutical effect or the independent restitution for the patient. Study from Eindhoven University, 2014 show future hospitalized

patients will require these kind of stimulus, comforts and welfare technologies even hospitals see potential to reduce costs and increase patient satisfaction.



Terms of the study

The effects of this combined light, color, image, and sound intervention were considered in relation to three parameters (Lundmark 2014):

● effect on the birth outcome ● patient satisfaction ● work environment

The study followed a qualitative study methodology with 3 components: 1)102 women/couples were given questionnaires that asked them about their satisfaction with the Sensory Delivery Room; 2) Participant observation of

and individual qualitative interviews with 5 women/couples that had given birth in the Sensory Delivery Room; 3) A qualitative evaluation of the midwifes’ experiences working the in the Sensory Delivery Room via participant

observation and a focus group interview with 5 midwifes.

With regard to birth outcome parameter, it was hypothesized that the Sensory Delivery Room would help create physiological conditions in the mother that would

induce the production of oxytocin hormone which would allow the woman to give birth more quickly, that would thus require fewer medical interventions, and perhaps lessen the need for pain medication. The researchers determined

that a random control study of birth outcomes would need to follow up this initial study to confirm positive indications on this first parameter.



Maternity Ward, North Zealand Hospital, study,

The Sensory Delivery Room’s sensory experience implemented in North Zealand Hospital Maternity Ward consisted of three Wavecare themes displayed on a screen creating a blurred image, to make it less dominant more an implicit dynamic light source appealing to the creativity inside the human being.

• Welcome Program with scenes providing a calm and welcoming atmosphere.

• Relaxation Program with the aim to provide a sense of relaxation and comfort (security) for the woman in labor.

• Breathing Program supports the breathing rhythm of the woman during contractions. This rhythm is illustrated via images of and sounds of lightly breaking foamy waves.

Welcome and relaxation accompanied by the music, Musicure.

A control panel assure a simple user interphase and easy employment.

Most significantly, the Sensory Delivery Room developed by Wavecare and Philips produced extremely impressive results with regard to patient and staff satisfaction.



Woman in labor experiences From the patient questionnaire on satisfaction with the Sensory Delivery Room, 102 questionnaires:

Impact on the birth experience, 93 % of women responded that the room had a very positive impact on the experience.

Pain perception during labor, 73% percent said it had a positive impact.

Experience of security and well-being during labor, 94% of the women said it had a very positive impact.



7%

93%

27%

73%

4%

96%

In the individual qualitative interviews, the women reported that the Sensory Delivery Room made a difference on a number of fronts, including:

● sense of control

● security and well-being ● pain management

● improved patient/healthcare provider communication

They reported the room felt home-like and thereby afforded them more of a sense of control.

“The light, sound and themes contributes to create a nice, tranquil, confidence-inspiring and distressing atmosphere at the ward”

“You feel welcome and the sensory delivery room creates an individual experience. The room seems more homey and less clinical”

“It move focus from the intense experience and makes it easier to relax between the labor pain and following under stitching”

Summing up from interviews:

Sara spoke about how the sensory delivery room helped to avoid distracting. She experienced that a room inside the room was created which helped to keep in control and not getting distracted, ex. by other staff, food/beverage trolly.

To stay focused was one of Saras most important observations, and the room helped her to create her own condition for feeling secure and safe. Sara liked the blurred images since they did not become too dominant together with the music which she really liked.

In the final stage, she became more withdrawn and had her eyes closed in the final labor phase. But Sara sensed the room all the time, which gave her the feeling of security.



In general from the feedback the light, sound and themes makes it easier to relax between the contractions and help to distract from pain.

Specially during the opening cervical dilation stage the breathing was supported from the room (breathing exercise)/ Latent phase to Active labor. Several did not notice anything in the transition phase to complete delivery.

Summing up from interviews:

Rikke experienced that the breathing exercise helped her to sustain her breathing during the contractions.

Jonas, Saras husband noticed Sara synchronized her breathing to the wave sound instinctively and Jonas used the breathing exercise to help Sara to assist her in the correct breathing.

They also reported that the comfort and tranquility emanating from the Sensory Delivery Room gave them a solid base from which to handle the often technical, medical discussions going on around them and the frequently quite difficult physical circumstances.

Second-time mother experiencing more empathy from the midwifes and that the ambient environment was more conductive to conversation in between contractions, for example, and not just when physical symptoms were most pronounced.

Statements from interviews:Sara discovered opposite her two earlier deliveries, that the midwife spoke to her between the contractions and not only during, like with her two earlier. Last time the midwife only spoke to me when it hurt, this time they spoke also in between which was very nice, I don't know if they are aware about that?



The positive delivery experience is created by the people inside the room and the midwifes presence is therefore important. The Sensory Delivery Room has contributed by “framing” the ambience around the woman in labor and keep disturbances outside which strengthen the presence of the midwife and her attendance is becoming more evident.

This observation is verified by the midwifes experiences:

“…in a normal delivery room it is maybe more the contraction you focus at and inside the Sensory Delivery Room it is also the breaks…”

An important reflection from the midwifes is the importance of the ambient continuity during the delivery procedure and even after the delivery, keeping the sensory stimuli turned on. This very clearly indicates that the themes should be maintained during the entire procedure.



Staff experiences

The maternity ward staff, in this case, midwifes’ attitudes toward the Sensory Delivery Room were also explored. Here too, the Sensory Delivery Room developed by Wavecare and Philips was very well received. In a focus group interview, the midwifes felt the ambient room made a significant difference in ways that correspond to the patients’ experience of the Sensory Delivery Room, and in other significant ways (MSA, Lundmark 2014):

• Improved communication between patients and midwifes

• Patient feelings of security and well-being

• Pain management

• Patients regulation of breathing

• Speed of delivery

• Experienced night shifts as more relaxing

• Professional satisfaction

An important observation from the midwifes inside the Sensory Delivery Room - they feel more present and attentive together with the woman in labor.

Midwifes observes that, specially during cervical dilation phase, creates the largest impact on the pain management.

Midwifes conclude that pain management for the woman in labor work better inside the Sensory Delivery Room, since they seem more safe in the less clinical environment.



This does not mean that the woman in labor discovers less pain inside the Sensory Delivery Room, but seems like they can manage the pain experience differently by being more in control.

Summing up from the interviews:

As midwife we can use the Sensory Delivery Room as a tool to guide the woman in labor to use her breathing more constructive. But also in the pressure phase the woman has unconscious benefits. Even when the woman in labor has her eyes closed several announced following after delivery they sensed the soft light inside room which gave the feeling of security.

It is observed that the woman in labor discover less stress inside the Sensory Delivery Room, and why they maybe give birth faster than with other delivery rooms. /needs to be further investigated

It is physical and mental hard to work as midwife with day/night/weekend shifts. But a nightshift at the Sensory Delivery Rooms lives through easier than on a night shift at a normal delivery room. The night seems much more manageable since the ambience is positive with the soften light. The midwifes observes that the Sensory Delivery Rooms creates tranquility that makes you relax in a positive way.

…” I don't know if my sleep has become better after a night duty, but for sure my workflow seems different and I feel less fatigue. I stay more inside the Sensory Delivery Room than on the normal rooms and do not feel the need to diversity, like going for coffee, toilet or chat with collages”

The two most important parameters for the midwifes inside this project and in general:

- A safe delivery for mother and child.

- A positive experience for mother and father.


RESTORATIVE BENEFITS WITH WAVECARE SENSORY

The midwifes obligation is to create a good delivery experience and bring the woman in labor strengthened through the labor process.

..” As midwifes we have a desire to create an increased self-confidence for the woman in labor and the experience around the labor procedure is crucial to our professional integrity”

The Sensory Delivery Room leaves the opportunity for the midwife to draw herself a little to the side and not necessarily need to fill out the silence in between the contractions. The room fills out the sentiment between the woman and the midwife becomes present and attentive when needed which is an interesting observation.

The Sensory Delivery Rooms creates the possibility to conduct the paradigm to remove sweat, tears, do massage on the lumbar area or simply give a hug.

In general all midwifes inside the study announces the Sensory Delivery Room generate alternative thinking which increases the professional integrity.

..” I feel more active inside the Sensory Delivery Room, doing alternative efforts”.

Conclusion Most significantly for these midwifes, perhaps, is that working in the Sensory Delivery Room gave them particular professional satisfaction in that they felt the room contributed to their practicing care in line with traditional midwife values.

The Sensory Delivery Rooms creates a special ambience for both midwife and woman in labor, and help to distract from pain and guide the breathing in different stages. Further investigation is needed to proof faster delivery, reduction in cesarean sections, which is moderate indicated inside this study.



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