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Multicentre cross-sectional study on adverse events and good practices in maternity wards in Brazil and Mexico: same problems, different magnitude

OBJECTIVE: To evaluate the quality of delivery care in maternity wards in Brazil and Mexico based on good practices (GP) and adverse events (AE), in order to identify priorities for improvement. DESIGN: A multicentre cross-sectional study with data collection from medical records between 2015 and 20...

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Autores principales: Sousa, Kelienny de Meneses, Pimenta, Isac Davidson Santiago Fernandes, Fernández Elorriaga, María, Saturno-Hernandez, Pedro Jesus, Rosendo, Tatyana Maria Silva de Souza, de Freitas, Marise Reis, Medeiros, Wilton Rodrigues, Martins, Quenia Camille Soares, Gama, Zenewton André da Silva
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6937348/
https://www.ncbi.nlm.nih.gov/pubmed/31888924
http://dx.doi.org/10.1136/bmjopen-2019-030944
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author Sousa, Kelienny de Meneses
Pimenta, Isac Davidson Santiago Fernandes
Fernández Elorriaga, María
Saturno-Hernandez, Pedro Jesus
Rosendo, Tatyana Maria Silva de Souza
de Freitas, Marise Reis
Medeiros, Wilton Rodrigues
Martins, Quenia Camille Soares
Gama, Zenewton André da Silva
author_facet Sousa, Kelienny de Meneses
Pimenta, Isac Davidson Santiago Fernandes
Fernández Elorriaga, María
Saturno-Hernandez, Pedro Jesus
Rosendo, Tatyana Maria Silva de Souza
de Freitas, Marise Reis
Medeiros, Wilton Rodrigues
Martins, Quenia Camille Soares
Gama, Zenewton André da Silva
author_sort Sousa, Kelienny de Meneses
collection PubMed
description OBJECTIVE: To evaluate the quality of delivery care in maternity wards in Brazil and Mexico based on good practices (GP) and adverse events (AE), in order to identify priorities for improvement. DESIGN: A multicentre cross-sectional study with data collection from medical records between 2015 and 2016 to compare indicators of maternal and neonatal GP and EA based on the Safe Childbirth Checklist and standardised obstetric quality indicators. Two Brazilian and five Mexican maternity wards participated in the study. Descriptive statistics and χ(2) tests were performed to assess performance and significant differences between the hospitals investigated. SAMPLING: We analysed 720 births in Brazil and 2707 in Mexico, which were selected using a systematic random sampling of 30 medical records every fortnight for 12 2-week periods in Brazil and 18 2-week periods in Mexico. We included women and their newborns, excluding those with congenital malformations. RESULTS: The Mexican hospitals showed greater adherence to GP (58.2%) and a lower incidence of AE (12.9%) than the participating institutions in Brazil (26.8% compliance with GP and 16.0% AE). In spite of these differences, the relative importance of particular quality problems and type of AE are similar in both countries. Tertiary hospitals, caring for women at higher risk, have significantly (p<0.001) higher rates of AE (27.2% in Brazil and 29.6% in Mexico) than institutions attending women at lower risk, where the frequency of AE ranges from 4.7% to 11.2%. Differences were significant (p<0.001) for most indicators of GP and AE. CONCLUSION: Data from outcome and process measures revealed similar types of failures in the quality of childbirth care in both countries and indicate the need of rationalising the use of antibiotics for the mother and episiotomy, encouraging greater adherence to partograph and to the use of magnesium sulfate for the treatment of severe preeclampsia/eclampsia.
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spelling pubmed-69373482020-01-09 Multicentre cross-sectional study on adverse events and good practices in maternity wards in Brazil and Mexico: same problems, different magnitude Sousa, Kelienny de Meneses Pimenta, Isac Davidson Santiago Fernandes Fernández Elorriaga, María Saturno-Hernandez, Pedro Jesus Rosendo, Tatyana Maria Silva de Souza de Freitas, Marise Reis Medeiros, Wilton Rodrigues Martins, Quenia Camille Soares Gama, Zenewton André da Silva BMJ Open Public Health OBJECTIVE: To evaluate the quality of delivery care in maternity wards in Brazil and Mexico based on good practices (GP) and adverse events (AE), in order to identify priorities for improvement. DESIGN: A multicentre cross-sectional study with data collection from medical records between 2015 and 2016 to compare indicators of maternal and neonatal GP and EA based on the Safe Childbirth Checklist and standardised obstetric quality indicators. Two Brazilian and five Mexican maternity wards participated in the study. Descriptive statistics and χ(2) tests were performed to assess performance and significant differences between the hospitals investigated. SAMPLING: We analysed 720 births in Brazil and 2707 in Mexico, which were selected using a systematic random sampling of 30 medical records every fortnight for 12 2-week periods in Brazil and 18 2-week periods in Mexico. We included women and their newborns, excluding those with congenital malformations. RESULTS: The Mexican hospitals showed greater adherence to GP (58.2%) and a lower incidence of AE (12.9%) than the participating institutions in Brazil (26.8% compliance with GP and 16.0% AE). In spite of these differences, the relative importance of particular quality problems and type of AE are similar in both countries. Tertiary hospitals, caring for women at higher risk, have significantly (p<0.001) higher rates of AE (27.2% in Brazil and 29.6% in Mexico) than institutions attending women at lower risk, where the frequency of AE ranges from 4.7% to 11.2%. Differences were significant (p<0.001) for most indicators of GP and AE. CONCLUSION: Data from outcome and process measures revealed similar types of failures in the quality of childbirth care in both countries and indicate the need of rationalising the use of antibiotics for the mother and episiotomy, encouraging greater adherence to partograph and to the use of magnesium sulfate for the treatment of severe preeclampsia/eclampsia. BMJ Publishing Group 2019-12-29 /pmc/articles/PMC6937348/ /pubmed/31888924 http://dx.doi.org/10.1136/bmjopen-2019-030944 Text en © Author(s) (or their employer(s)) 2019. 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 Public Health
Sousa, Kelienny de Meneses
Pimenta, Isac Davidson Santiago Fernandes
Fernández Elorriaga, María
Saturno-Hernandez, Pedro Jesus
Rosendo, Tatyana Maria Silva de Souza
de Freitas, Marise Reis
Medeiros, Wilton Rodrigues
Martins, Quenia Camille Soares
Gama, Zenewton André da Silva
Multicentre cross-sectional study on adverse events and good practices in maternity wards in Brazil and Mexico: same problems, different magnitude
title Multicentre cross-sectional study on adverse events and good practices in maternity wards in Brazil and Mexico: same problems, different magnitude
title_full Multicentre cross-sectional study on adverse events and good practices in maternity wards in Brazil and Mexico: same problems, different magnitude
title_fullStr Multicentre cross-sectional study on adverse events and good practices in maternity wards in Brazil and Mexico: same problems, different magnitude
title_full_unstemmed Multicentre cross-sectional study on adverse events and good practices in maternity wards in Brazil and Mexico: same problems, different magnitude
title_short Multicentre cross-sectional study on adverse events and good practices in maternity wards in Brazil and Mexico: same problems, different magnitude
title_sort multicentre cross-sectional study on adverse events and good practices in maternity wards in brazil and mexico: same problems, different magnitude
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6937348/
https://www.ncbi.nlm.nih.gov/pubmed/31888924
http://dx.doi.org/10.1136/bmjopen-2019-030944
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