Abstract
Background: While telephone triage (TT) is common in other clinical disciplines, its use in midwifery is limited. It has significant potential for managing low-risk cases and reducing unnecessary visits, although logistical and medico-legal barriers remain. The aim of this study was to investigate midwives’ experiences and practices in TT management in Italy.
Participants and Methods: A quantitative and qualitative descriptive study involving midwives employed in Italian maternity hospitals was conducted. For the quantitative phase, an online questionnaire was administered via social networks, and for the qualitative phase, midwives were invited to join online focus groups.
Results: The quantitative phase included 224 respondents, 50.9% of whom worked in advanced care maternity hospitals. Approximately 98% received calls from pregnant women, with 59.7% requesting specific information. Training in TT was lacking for 76.8%, while 92.4% lacked tools for managing TT. Key concerns included medico-legal issues and the inability to assess women face-to-face. Key aspects of effective TT management were considered an adequate training and a dedicated service.
For the qualitative phase, 16 midwives participated in two focus groups. Three themes emerged: 1) current TT use and organisation, 2) competencies and resources, and 3) strengths and weaknesses. Despite recognising the numerous strengths of TT in improving clinical practice, midwives do not feel confident in providing telephone consultations, especially for medico-legal reasons, if the TT service is not official and structured.
Conclusions: Standardised systems, training, and dedicated services are crucial to enhancing midwives’ confidence and safety regarding TT, ensuring clear documentation, and addressing medico-legal concerns to improve clinical practice