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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...

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Autores principales: Mukhtar-Yola, Mariya, Audu, Lamidi Isah, Olaniyan, Oluyinka, Akinbi, Henry T, Dawodu, Adekunle, Donovan, Edward F
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
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.
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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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