| Using criteria-based audit to improve the management of postpartum haemorrhage in resource limited countries: a case study of Malawi. | |
| | |
MedLine Citation:
|
PMID: 18780170 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: The goal of this study was to assess and improve the management of postpartum haemorrhage (PPH) in maternity units in Malawi. The main objective was to determine whether criteria-based audit can improve adherence to standards for the management of PPH. METHODS: We used a before-and-after design and univariate statistics for data analysis. A retrospective review of 40 consecutive cases of PPH was conducted in eight hospitals and the results compared with standards for PPH, established based on World Health Organisation manuals. RESULTS: of the audit were presented to healthcare providers who made and implemented recommendations for improvement. A re-audit (45 cases) was conducted 3 months later. RESULTS: There was a significant improvement in adherence to three standards: typing and cross-match carried out (65.0% vs. 84.4%; P = 0.034), patient's hematocrit or haemoglobin established (67.5% vs. 86.7%; P = 0.029), and fluid intake/output chart maintained (0.0% vs 33.3%; P < 0.001). There was no significant change in close monitoring of vital signs (32.5% vs. 53.3%, P = 0.065) and case fatality rate (10.0% vs. 6.7%, P = 0.702), intravenous access achieved and intravenous fluids administered (100.0% vs. 97.8%; P = 0.735), and oxytocic drugs administered (100.0% vs. 95.6%; P = 0.357). CONCLUSION: Introduction of criteria-based audit can improve the management of postpartum haemorrhage in countries with limited resources. Future studies should consider using larger sample size to evaluate the effect of criteria-based audit on mortality. |
| | |
Authors:
|
Eugene J Kongnyuy; Grace Mlava; Nynke van den Broek |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2008-09-09 |
Journal Detail:
|
Title: Maternal and child health journal Volume: 13 ISSN: 1573-6628 ISO Abbreviation: Matern Child Health J Publication Date: 2009 Nov |
Date Detail:
|
Created Date: 2009-10-09 Completed Date: 2010-01-25 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9715672 Medline TA: Matern Child Health J Country: United States |
Other Details:
|
Languages: eng Pagination: 873-8 Citation Subset: IM |
Affiliation:
|
Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK. kongnyuy@liverpool.ac.uk |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Emergency Service, Hospital Female Guideline Adherence / standards Humans Malawi / epidemiology Maternal Health Services / standards Medical Audit* Postpartum Hemorrhage / mortality, therapy* Quality of Health Care / organization & administration*, standards Retrospective Studies |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Racial disparities in pregnancy-related drinking reduction.
Next Document: Implementation of Culturally and Linguistically Competent Policies by State Title V Children with Sp...