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Misinterpretation of CTG can be a common occurrence in practice, but using a simple buddy system can yield significant improvements, as Lorraine Donnelly and Linda Hamilton found.
In 2010, a group of supervisors of midwives (SoMs) from NHS Forth Valley identified current themes of misinterpretation of cardiotocography (CTG) and poor documentation through a process of investigation and case note review. It was decided that a robust and innovative practice known as a 'buddy system' was to be formally implemented.
A 'fresh eyes approach' (Fitzpatrick and Holt, 2008) can enhance the accuracy of CTG interpretation as the tracings are viewed by more than one person. Fitzpatrick and Holt (2008) found that two people operating together as a single unit are able to monitor and help each other, leading to a learning process essential for effective professional practice. Symon et al (2006) support this theory and note that what often prevents an adverse outcome in midwifery is incidental intervention by another practitioner. The process identifies areas that can lead to misinterpretation on CTG tracings: fatigue, familiarity and limited knowledge.
Statutory supervision has operated within the UK for over 100 years (NMC, 2002). It was introduced in England and Wales through the Midwives Act 1902, and through similar legislation in Scotland and Ireland in 1915 and 1918 respectively (NMC, 2002). Monitoring standards of midwifery practice through audit of records and assessment of clinical...