UK consensus guidelines for the delivery of unexpected news in obstetric ultrasound: The ASCKS framework

Johnson, Judith;Arezina, Jane;Tomlin, Liz;Alt, Siobhan;Arnold, Jon;Bailey, Sarah;Beety, Hannah;Bender-Atik, Ruth;Bryant, Louise;Coates, Jen;Collinge, Sam;Fishburn, Jo;Fisher, Jane;Fowler, Jan;Glanville, Tracey;Hallett, Julian;Harley-Roberts, Ailith;Harrison, Gill;Horwood, Karen;Hynes, Catriona;Kimm, Lindsay;McGuinness, Alison;Potter, Lucy;Powell, Liane;Ramsay, Janelle;Shakes, Pieta;Sicklen, Roxanne;Sims, Alexander;Stacey, Tomasina;Sumra, Anushka;Thomas, Samantha;Todd, Karen;Torrington, Jacquie;Trueman, Rebecca;Walsh, Lorraine;Watkins, Katherine;Yaz, Gill;Hardicre, Natasha K.

Pieta Shakes

Abstract

Background: Studies indicate there is a need to improve the delivery of unexpected news via obstetric ultrasound, but there have been few advances in this area. One factor preventing improvement has been a lack of consensus regarding the appropriate phrases and behaviours which sonographers and ultrasound practitioners should use in these situations. Aims: To develop consensus guidelines for unexpected news delivery in Early Pregnancy Unit and Fetal Anomaly Screening Programme NHS settings. Methods: A workshop was conducted to identify priorities and reach consensus on areas of contention. Contributors included interdisciplinary healthcare professionals, policy experts, representatives from third-sector organisations, lay experts and academic researchers (n = 28). Written and verbal feedback was used to draft initial guidance which was then circulated amongst the wider writing group (n = 39). Revisions were undertaken until consensus was reached. Results: Consensus guidelines were developed outlining the behaviours and phrases which should be used during scans where unexpected findings are identified. Specific recommendations included that: honest and clear communication should be prioritised, even with uncertain findings; technical terms should be used, but these should be written down together with their lay interpretations; unless expectant parents use other terminology (e.g. ‘foetus’), the term ‘baby’ should be used as a default, even in early pregnancy; at the initial news disclosure, communication should focus on information provision. Expectant parents should not be asked to make decisions during the scan. Conclusions: These recommendations can be used to develop and improve news delivery interventions in obstetric ultrasound settings. The full guidelines can be accessed online as supplemental material and at https://doi.org/10.5518/100/24.

Journal

Ultrasound

Publication Name

N/A

Volume

ISBN/ISSN

1743-1344

Edition

N/A

Issue

Pages Count

Location

N/A

Publisher

Sage Publications

Publisher Url

N/A

Publisher Location

N/A

Publish Date

N/A

Url

N/A

Date

N/A

EISSN

N/A

DOI

10.1177/1742271X20935911