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Decreasing birth asphyxia: utility of statistical process control in a low-resource setting
The neonatal period is a critical time for survival of the child. A disproportionate amount of neonatal deaths occur in low-resource countries and are attributable to perinatal events, especially birth asphyxia. This project aimed to reduce the incidence of birth asphyxia by 20% by June 2014 through...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6135449/ https://www.ncbi.nlm.nih.gov/pubmed/30234170 http://dx.doi.org/10.1136/bmjoq-2017-000231 |
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author | Mukhtar-Yola, Mariya Audu, Lamidi Isah Olaniyan, Oluyinka Akinbi, Henry T Dawodu, Adekunle Donovan, Edward F |
author_facet | Mukhtar-Yola, Mariya Audu, Lamidi Isah Olaniyan, Oluyinka Akinbi, Henry T Dawodu, Adekunle Donovan, Edward F |
author_sort | Mukhtar-Yola, Mariya |
collection | PubMed |
description | The neonatal period is a critical time for survival of the child. A disproportionate amount of neonatal deaths occur in low-resource countries and are attributable to perinatal events, especially birth asphyxia. This project aimed to reduce the incidence of birth asphyxia by 20% by June 2014 through training in neonatal resuscitation and improving the availability of resuscitation equipment in the delivery room in the National Hospital Abuja, Nigeria. A prospective, longitudinal study using statistical process control analytical methods was done enrolling babies delivered at the National Hospital Abuja. Low Apgar scores or birth asphyxia (defined a priori as any score <7 at 1, 5 and/or at 10 min) was assessed. To ensure reliability and validity of Apgar scoring, trainings on scoring were held for labour and delivery staff. Interventions included provision of additional equipment and trainings on neonatal resuscitation. Apgar scores were aggregated weekly over 25 months. Control charts with three SE confidence limits were used to monitor the proportion of scores ≤7. The baseline incidence of low Apgar scores, as defined a priori, was 33%, 17% and 10% while postintervention the incidence was 18%, 17% and 6% at 1, 5 and 10 min, respectively—a reduction of 45% and 40% in the 1-min and 10-min low Apgar scores. Increased communication, additional resuscitation equipment and training of delivery personnel on neonatal resuscitation are associated with reductions in measures of birth asphyxia. These improvements have been sustained and efforts are ongoing to spread our interventions to other special care delivery units/nursery in adjoining states. Our study demonstrates the feasibility and utility of using improvement science methods to assess and improve perinatal outcome in low-resource settings. |
format | Online Article Text |
id | pubmed-6135449 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-61354492018-09-19 Decreasing birth asphyxia: utility of statistical process control in a low-resource setting Mukhtar-Yola, Mariya Audu, Lamidi Isah Olaniyan, Oluyinka Akinbi, Henry T Dawodu, Adekunle Donovan, Edward F BMJ Open Qual BMJ Quality Improvement report The neonatal period is a critical time for survival of the child. A disproportionate amount of neonatal deaths occur in low-resource countries and are attributable to perinatal events, especially birth asphyxia. This project aimed to reduce the incidence of birth asphyxia by 20% by June 2014 through training in neonatal resuscitation and improving the availability of resuscitation equipment in the delivery room in the National Hospital Abuja, Nigeria. A prospective, longitudinal study using statistical process control analytical methods was done enrolling babies delivered at the National Hospital Abuja. Low Apgar scores or birth asphyxia (defined a priori as any score <7 at 1, 5 and/or at 10 min) was assessed. To ensure reliability and validity of Apgar scoring, trainings on scoring were held for labour and delivery staff. Interventions included provision of additional equipment and trainings on neonatal resuscitation. Apgar scores were aggregated weekly over 25 months. Control charts with three SE confidence limits were used to monitor the proportion of scores ≤7. The baseline incidence of low Apgar scores, as defined a priori, was 33%, 17% and 10% while postintervention the incidence was 18%, 17% and 6% at 1, 5 and 10 min, respectively—a reduction of 45% and 40% in the 1-min and 10-min low Apgar scores. Increased communication, additional resuscitation equipment and training of delivery personnel on neonatal resuscitation are associated with reductions in measures of birth asphyxia. These improvements have been sustained and efforts are ongoing to spread our interventions to other special care delivery units/nursery in adjoining states. Our study demonstrates the feasibility and utility of using improvement science methods to assess and improve perinatal outcome in low-resource settings. BMJ Publishing Group 2018-09-04 /pmc/articles/PMC6135449/ /pubmed/30234170 http://dx.doi.org/10.1136/bmjoq-2017-000231 Text en © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | BMJ Quality Improvement report Mukhtar-Yola, Mariya Audu, Lamidi Isah Olaniyan, Oluyinka Akinbi, Henry T Dawodu, Adekunle Donovan, Edward F Decreasing birth asphyxia: utility of statistical process control in a low-resource setting |
title | Decreasing birth asphyxia: utility of statistical process control in a low-resource setting |
title_full | Decreasing birth asphyxia: utility of statistical process control in a low-resource setting |
title_fullStr | Decreasing birth asphyxia: utility of statistical process control in a low-resource setting |
title_full_unstemmed | Decreasing birth asphyxia: utility of statistical process control in a low-resource setting |
title_short | Decreasing birth asphyxia: utility of statistical process control in a low-resource setting |
title_sort | decreasing birth asphyxia: utility of statistical process control in a low-resource setting |
topic | BMJ Quality Improvement report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6135449/ https://www.ncbi.nlm.nih.gov/pubmed/30234170 http://dx.doi.org/10.1136/bmjoq-2017-000231 |
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