Midwives and perinatal data entry : an analytical approach to understanding process

Introduction: Across Queensland midwives collect birth related data via the perinatal data collection form in either a paper or online format. This data is then transferred to the perinatal data collection unit of Queensland Health who purport that “the quality of information produced from the perinatal data collection depends on the accurate, consistent and timely completion of the forms (QHealth Perinatal Data Unit, 2010:201). The version submitted often differs from the medical record which means that the many and varied services that the perinatal data collection provides information for, funding, resource planning, research, education, are compromised. This research will develop a substantive grounded theory after an in-depth analysis of the processes used by midwives to record birth related data. The objectives of the research are to examine issues that contribute to midwives data entry. This research will contribute to knowledge by understanding the factors that influence the practice of midwives in the process of birth related data entry. Specifically, an examination of processes used by midwives to enter data onto paper charts and into the online perinatal data form will be undertaken. Research outcomes will assist nursing management, nurses in informatics and information managers to understand current practice. This knowledge can then be used to provide education and contribute to improved design in information systems that are used to collect data in obstetrics. With the impending move to increase eHealth technologies used in health care, it is necessary to understand the processes midwives use to enter data using eHealth so the move away from manual paper data entry can be done while maintaining data integrity.