Telephone triage in midwifery practice: A cross-sectional survey

Background: Childbearing women commonly access maternity services via the telephone. A midwife receiving these calls listens to the woman's concerns and then triages women according to their assessment. This may result in the provision of advice and instruction over the telephone or inviting the woman into the health service for further assessment. Midwives are responsible for all care and advice given to women, including via the telephone. Objectives: The purpose of this study was to explore the experiences and practices of midwives regarding their management of telephone triage. Design: A cross-sectional survey. Setting and participants: Purposive non-probabilistic sampling of currently practising midwife members of professional organisations was used to recruit participants. From this, 242 midwives responded and 230 returned valid surveys were used in data analysis. Methods: Participant demographics, telephone triage processes, skills, educational preparation, confidence and anxiety levels, and external factors that influence midwives’ management of telephone triage were collected via an on-line survey. Descriptive statistics and further analyses were conducted to explore relationships between variables. Results: Eighty-three percent of midwives respond to 2–5 telephone calls per shift, with only 11.7% (n = 24) of midwives reporting that this is included in their workloads. Telephone triage is frequently managed in environments with distractions. Most midwives (84%; n = 177) report receiving no training in this skill. Confidence in performing telephone triage was reported, with higher confidence levels related to midwives’ increased years of experience (p < 0.05) and age (p < 0.01). Anxiety related to managing telephone triage has been experienced by 73% (n = 151) of midwives, with this being greater in midwives with less years of experience. Anxiety is reported less by midwives in rural or remote settings compared to metropolitan or regional (p < 0.05) settings in this study. A variety of standards and aids to guide practice, and document calls are utilised in a range of ways. Conclusion: To the authors’ knowledge, this is the first study conducted to explore midwives’ practises in telephone triage. The findings suggest the need for appropriate environments to conduct telephone calls and the inclusion of telephone triage in midwifery workloads. In addition, consistent education and processes are required to reduce anxiety and support midwives provision of this service to women.