Document Detail


Successful implementation of evidence-based routines in Ukrainian maternities.
MedLine Citation:
PMID:  20121338     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To describe the process of change and assess compliance and effect on maternal and infant outcome when the WHO package Effective Perinatal Care (EPC) was implemented at maternities in Ukraine. DESIGN: Intervention study comparing outcomes before and during 2.5 years after training. SETTING: Three maternities in Donetsk, Lutsk and Lviv 2003-2006. POPULATION: Baseline data were collected for 652, 742 and 302 deliveries and 420, 381 and 135 infants, respectively, in Donetsk, Lutsk and Lviv. Follow-up data included 4,561, 9,865 and 7,227 deliveries and 3,829, 8,658 and 6,401 infants. METHODS: Staff training on evidence-based guideline. MAIN OUTCOME MEASURES: Interventions during labor, maternal outcomes and hypothermia in the infants. RESULTS: EPC procedures were successfully implemented and adherence to the protocols was excellent. For most variables, the change occurred during the first three months but was well sustained. The use of partogram increased fourfold in Donetsk and from 0% to 60% in Lviv. Induction and augmentation of labor decreased to less than 1% and less than 5%, respectively. Cesarean section rate dropped significantly in two of the maternities. The proportion of hypothermic infants decreased from 60% (Donetsk), 85% (Lutsk) and 77% (Lviv) to 1% in all three maternities during the first three months and was stable throughout the study period. Admission to Neonatal Intensive Care Unit decreased significantly in two of the maternities and there was no effect on early neonatal mortality. CONCLUSIONS: The process of education and change was well anchored in the organization, and implementation of new procedures was quick and successful.
Authors:
Anna Berglund; Helene Lefevre-Cholay; Alberta Bacci; Anna Blyumina; Gunilla Lindmark
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  89     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2010  
Date Detail:
Created Date:  2010-02-03     Completed Date:  2010-03-04     Revised Date:  2010-04-07    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  230-7     Citation Subset:  IM    
Affiliation:
Department of Obstetrics/Gynecology, Central Hospital, V?ster?s SE-721 89, Sweden. anna.berglund@kbh.uu.se
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Analgesia, Obstetrical / statistics & numerical data
Cesarean Section / statistics & numerical data
Clinical Protocols
Delivery Rooms
Evidence-Based Medicine*
Extraction, Obstetrical / statistics & numerical data
Female
Hospitals, Maternity / standards*
Humans
Hypothermia / epidemiology,  prevention & control
Infant, Newborn
Inservice Training
Intensive Care Units, Neonatal
Labor, Induced / statistics & numerical data
Medical Staff, Hospital / education*
Middle Aged
Nursing Staff, Hospital / education*
Patient Admission / statistics & numerical data
Perinatal Care / standards*
Pregnancy
Resuscitation / statistics & numerical data
Temperature
Ukraine / epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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