Data collection of antenatal steroids given - a case study for NNAP

The following case study from Calderdale and Huddersfield NHS Foundation Trust was included in the 2018 annual report on 2017 data, and highlights how NNAP results can be used as a basis for identifying, and undertaking, local quality improvement activities.


Our main aim was to improve our rates of administration of antenatal steroids. Looking at our NNAP data for 2016, our rate for administration had dropped to 81% (from 93% in 2015). We wanted to see what had caused this change.

What we did

We planned to measure the improvement by comparing our 2017 data.

Firstly, we questioned what changes could have had an impact on our practice. The main change in our Trust was that our maternity system had moved from our old PAS (Patient Administration System) to Athena (run by K2), and the maternity team had gone paperless. 

We requested and established an interface between Athena and BadgerNet to pull the maternity details through for the baby admission when Athena replaced our old system. This has been working well, but the Athena system did not have a set place to record when steroids had been given. Information was being missed as it was documented in various places not always obvious to neonatal staff.

Once we realised this, we worked with the maternity electronic patient record (EPR) midwives to add a separate tab in Athena to capture that steroids had been given, the courses and the dates and times.

The next issue was to re-educate staff to document in the designated tab. Documentation was reviewed on a weekly basis and staff were notified by email of any errors relating to missing details.

At the same time, we notified the obstetric team of babies who did not have steroids documented so they could review why.

What we achieved

Our expected NNAP results indicate that we are up to 94.5% antenatal steroid administration for 2017, which is an excellent achievement.

Our next project is to develop a tab within Athena to record administration of magnesium sulphate neuroprotection. Again, this will also be beneficial for the maternity team.

Top tips for implementation

  • Meet with maternity staff to discuss how they work with their EPR systems.
  • Keep in touch with the maternity team, things change for them too in practice and EPR.
  • Find a “named” person in your IT department to work with who understands what you want to achieve.

Presented by

Hazel Williams, NNEB, BadgerNet System Data Officer

Calderdale & Huddersfield NHS Foundation Trust


  • K2 and Clevermed, who were very helpful in assisting us with interfacing and testing of the system
  • The IT department at Calderdale
  • Emma Hardwidge and Carol Gregson, Maternity EPR Midwifes at Calderdale, who have assisted throughout