This thesis, Quality Assurance Project Safe Births – an analysis of the improvement project influence on the health workers knowledge construction and practice culture, investigates the predominant construction of knowledge in the Danish labour culture throughout the past decades, which has resulted in administration of oxytocin use in close to 50% primiparous women. The thesis is based on the comprehensive national quality assurance project: Projekt Sikre Fødsler (Project Safe Births), which aims to reduce asphyxia incidents at birth by 50% - often due to malpractice, by focussing on the ‘Oxytocin Use Package’ (S-drop pakken). The project involves all midwives and obstetricians nationally, and my thesis investigates the impact the project has on the construction of knowledge and labour culture around oxytocin use as well as it investigates what impact the implementation of the project, has on the daily work of healthcare practitioners. This is illustrated by seven qualitative interviews with a chief obstetrician, an obstetrician, a senior midwife and four midwives at Hvidovre Hospital, which is Denmark’s leading birthplace with approximately 7000 yearly births. Methodogically this thesis is placed within social constructivism and philosophical hermeneutics. My thesis further investigates the mechanisms of power in the Danish healthcare system and how these together with Project Safe Births, impact on healthcare practitioners and their daily work. I use Michel Foucault’s theoretical perspective on power, management and governmentality in modern society as a theoretical frame in the thesis, along with Steen Wackerhausen’s theories on the profession´s identity of healthcare professionals. Also, I am using theoretical material from articles, publications and guidelines, which has been published in relation to the implementation of Project Safe Births at all labour wards in Denmark. In addition I supply with other relevant input that combined with the theoretical perspective above, will be used in the analysis in this thesis and relevant conditions will be discussed throughout the thesis. This thesis concludes that Project Safe Births has put a focus on the occasionally malpractice labour culture, which was dominated by an active and often unnecessarily use of oxytocin. The analysis concludes that the implementation of Project Safe Births at Hvidovre Hospital’s labour ward, has laid the foundation for a radical change in the existing labour culture, which is now moving towards a more patient and restrictive labour culture as a result to the focus the project has led. The consequent focus on coherent and standardized communication and guidelines has had an impact today – and will hopefully have a long-term impact on the number of babies born with asphyxia, so we will benefit from a reduction in these and a significant increase in patient safety.
|Uddannelser||Sundhedsfremme og Sundhedsstrategier, (Bachelor/kandidatuddannelse) Kandidat|
|Udgivelsesdato||30 jun. 2014|
- Projekt Sikre Fødsler