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If you would prefer to contact the Early Pregnancy Unit for information and support, you can contact the Specialist Nursing Team for a consultation between 8:30 am and 5:30 pm, Monday to Friday. www.ectopic.org.ukSupporting people who have experienced an early pregnancy complication. We are a nurse-led service, supported by sonographers and the on-call gynaecology medical team, including a lead consultant . 1445/5464 (26.4%; 95%CI 25.3 to 27.6) women were admitted from ED. This avoids the need for patients/carers to park illegally on the day while they come in to get their dispensation notice. Monday to Sunday 08:00 to 13:00. Standard toilet facilities are available. Writing review & editing, Roles Referrals are accepted direct to the unit from GPs, Midwives and the Emergency Department. There is not a hearing assistance system. The bollard(s) has/have a good colour contrast to prevent them being hazardous to visually impaired people. There is a/are clearly marked/signposted Blue Badge parking bay(s) available. Methodology, Take the lift to the lower ground floor and on exiting turn right and go through the double doors. Bearing in mind that women attending the ED are eight times more likely to be admitted than those seen in the EPAU, keeping EPAUs open over the weekend reduces the overall number of emergency admissions to hospital. d) previous tubal surgery The UCLH email address for Blue Badge parking enquiries is. The Blue Badge bay(s) is/are clearly marked. We next investigated the relationship between emergency admissions from the Emergency Department and planned senior clinician presence in EPAU, unit volume and weekend opening hours of the EPAU. The towel dispenser cannot be reached from seated on the toilet. Clinical follow-up was not standardised but was based on local management protocols and womens medical needs. 44 Early Pregnancy Assessment Units (EPAUs) across the UK randomly selected in balanced numbers from eight pre-defined mutually exclusive strata. Having collected detailed data on the opening hours of all participating EPAUs over the weekend, we were able to identify that one hours increase in the weekend opening hours of an EPAU resulted, as expected, in an increased probability of a woman with first trimester complications being admitted to hospital from the EPAU, but decreased the chance of an admission to hospital from the Emergency Department. Funding acquisition, When we compared actual with planned senior clinicians presence, we found that in only 3/19 units (16%) did senior clinicians spend more than 15% of their time actively delivering clinical care, and in 13/19 units (68%) their actual documented presence was less than 5%. Please note: Dispensations are only issued to outpatients with Blue Badges who are attending hospital appointments. In this national prospective cohort study, we aimed to determine whether higher participation of senior clinicians in the delivery of first trimester pregnancy care would result in better quality clinical care reflected in a lower risk of acute admissions to hospital for women presenting with first trimester complications. Women are seen in order of clinical priority, which means that you may be in the department for longer than anticipated. There is level access into the day room/lounge area. The contrast between the dropdown rail(s) and wall is good. Guidelines: care is provided to women following guidelines that have been produced by the department. Conceptualization, Assessment is by appointment only following a consultation with a healthcare professional or telephone consultation with EPAU. If you are based within a GP practice please contact the GPIT Helpdesk on If you are not under the care of the EPAU, please contact your GP. Radiotherapy patients receive a dispensation notice directly from the Radiotherapy department. Payment signs are located at the payment machines in the hospital building. The variable Gestational Age Policy (GAP) captures whether units either accepted referrals for women of any gestational age or only reviewed women of six weeks gestation or more. No, Is the Subject Area "Pregnancy complications" applicable to this article? . The E&N Hertfordshire NHS Trust website uses cookies to improve your on-site experience. If you do not wish to have them in the room during your appointment, please let the nurse or doctor know and students can be asked to step outside. There is a horizontal wall-mounted grab rail on the opposite side of the seat to the transfer space. If you have a non-urgent concern not related to your pregnancy such as chest/urine/ear infections, skin complaints, viral infections, exposure to infections i.e chickenpox, you should see your GP for advice as they are better placed to help with these problems. There is a clear unobstructed route to the reception point. It is likely that the caller ID will show as a private number orwithheld number. The entrance area/door is not clearly signed. The height of the toilet seat above floor level is 48cm (1ft 7in). Funding acquisition, The reception counter is not placed in front of a background which is patterned. Visit the Miscarriage Association website which has a wide range of information as well as the different ways you can access support. Planned and actual senior clinician presence, unit size, and weekend opening. The distance between the floor and the highest table is 43cm (1ft 5in). Methodology, We could therefore calculate the actual amount of time senior clinicians spent in EPAU delivering clinical care. However, there was little evidence of an association with unit volume (p = 0.647) or planned senior clinician time (p = 0.280). We recommend upgrading your browser to continue. If you feel your symptoms require urgent assessment outside of these hours the wider medical team are here to support you 24 hours a day 7 days a week. This section describes the Ultrasound Room(s), located to the left along the department corridor. Access to the building between 21:00 - 07:00 is via intercom. Site map. The department/service does play background music. Funding acquisition, The emergency pull cord alarm is not fully functional. There is / are 10 consultation / treatment room(s) available. A member of staff is available to assist with opening the door if required. There is sufficient space for a wheelchair user to manoeuvre within the imaging room. There was little evidence of an association with planned senior clinician time (p = 0.280) or unit volume (p = 0.647). Both units accept referrals from GPs, the urgent care centre, the antenatal clinic and A&E. You may find that certain parts of the My CPD. Download the app Get a . No, Is the Subject Area "Hospitals" applicable to this article? An implantation bleed, when the pregnancy is settling into the womb lining, can be common at around 4-6 weeks. There is sufficient space next to the bed/couch for a mobile hoist to operate. This analysis was based on the 29 units (5,464 patients) that were able to provide us with reliable data regarding the attendances to Emergency Department and emergency admissions out of hours. Edna Keeney reports personal fees from Novartis Pharma, personal fees from Pfizer Inc., outside the submitted work. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. If our guide needs updating - just let us know using this form. We report the data from two of the VESPA study strands: 1) the prospective cohort study of women attending EPAUs due to first trimester complications; and 2) the emergency hospital care audit of women admitted as an emergency with first trimester pregnancy complications. Ultrasound based assessment for suspected pelvic pathology. Copyright 2023 Imperial College Healthcare NHS Trust, Early pregnancy and acute gynaecology units, Assessment of women with bleeding and/or pain in early pregnancy, Diagnosis and subsequent management of miscarriage and ectopic pregnancy, Nausea and vomiting in pregnancy (hyperemesis), Gynaecology: scans for suspected pelvic pathology requiring emergency review, Possible ovarian cyst accidents (ovarian cyst rupture or torsion), Significant heavy menstrual bleeding with anaemia requiring hospital admission, Expectant, medical and surgical management of miscarriage, Management of ectopic pregnancy: medical, surgical and close monitoring with expectant management, Inpatient and outpatient management of nausea and vomiting in pregnancy, Surgical management of molar pregnancy and liaison with the, Incision and drainage of Bartholins cysts and abscesses under local anaesthesia or general anaesthesia. Investigation, This is an important finding for health providers as the cost of employing senior clinicians is much higher compared to nurses and other healthcare professionals. Visiting restrictions are in place. The transfer space is obstructed by a waste disposal bin. The hospital entrance is clearly visible from the car park. Unfortunately, bleeding can also be associated with an ectopic pregnancy (where the pregnancy grows outside the womb) or a miscarriage. If necessary, patients can be admitted under the on-call gynaecology team 24 hours a day, seven days a week. You should still contact the Early Pregnancy Unit on the phone number below, which will inform you of where to call in the event of an emergency. Inside the venue, there is level access to the female toilet(s). Writing review & editing, Roles The height of the wash basin is 86cm (2ft 10in). No, Is the Subject Area "Cohort studies" applicable to this article? There are parking charges for the hospital car park. Detailed information, also Abdominal pain can also be related to non pregnancy causes including muscular pain, pain related to fibroids, urinary tract infection and other surgical causes egappendicitis. There is not a hearing assistance system. Department of Women and Childrens Health, Kings College London, London, United Kingdom, Roles We apologise for any inaccuracies in the following list of contributors, whose primary role has been described. We would advise you attend your local emergency department unitif bleeding worsens whereby you are having to change your sanitary pad more frequently and feel unwell, or ifyou are experiencing severe abdominal pain which is not improving with simple pain relief egparacetamol. A user-led organization (Miscarriage Association), through its national director, acted as a co-applicant and collaborator. Data Availability: All relevant data are within the papers Supporting information files. There is a dropdown rail on the transfer side. Pinderfields Hospital An ambulant toilet with wall mounted grab rails is available. If a family member or friend has accompaniedyou, the clinician will still request that a member of staff acts as chaperone for an intimate examination. The service is then located on the right. We ask that they call the unit so that we can book them a timed appointment. 9.00am 4.00pm Saturday, Sunday and Bank Holiday (except Christmas Day), 10.00 to 12.00 Sunday and Bank Holiday except 25th December, Clinical assessment if you present with symptoms in early pregnancy, USS scan to assess pregnancy, pelvis, ovaries, Medical/surgical/conservative management for miscarriage orectopic pregnancy, Surgical management of miscarriage under Local anaesthesia (MVA), Outpatient Treatment for hyperemesis (vomiting in early pregnancy), Outpatient treatment for Bartholins abscess, Telephone advise and follow up regarding further investigations, assessment of symptoms and management plans. For more information about PLOS Subject Areas, click The type of flooring in walkways and corridors is vinyl/laminate. Opening Times (Early Pregnancy Unit and Gynae Assessment Unit) Department / Service (Early Pregnancy Unit and Gynae Assessment Unit) Reception Consultation / Treatment Room (3) Imaging Room Day Room / Lounge Area (Quiet Room) Accessible Toilet (s) Related Access Guides Getting To The Hospital (Princess Anne Hospital) Collapse all By Road View For more information please contact Professor Tom Bourne, consultant gynaecologist by emailing t.bourne@ic.ac.uk at Queen Charlottes, or Dr Shahla Ahmed, consultant gynaecologist by emailing shahla.ahmed1@nhs.net at St Marys. We listen to patient feedbackto deliver patient-centred care.