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Using healthcare failure mode and effect analysis as a method of vaginal birth after caesarean section management

AIMS AND OBJECTIVES: This research was conducted to explore the effectiveness of employing the healthcare failure mode and effect analysis method in the management of trial of labour after caesarean, with the aims of increasing vaginal birth after caesarean section rate and reducing potential risks...

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Autores principales: Liu, Ying, Zhu, Wei, Le, Shiguan, Wu, Wenxian, Huang, Qun, Cheng, Weiwei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7328791/
https://www.ncbi.nlm.nih.gov/pubmed/31532033
http://dx.doi.org/10.1111/jocn.15069
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author Liu, Ying
Zhu, Wei
Le, Shiguan
Wu, Wenxian
Huang, Qun
Cheng, Weiwei
author_facet Liu, Ying
Zhu, Wei
Le, Shiguan
Wu, Wenxian
Huang, Qun
Cheng, Weiwei
author_sort Liu, Ying
collection PubMed
description AIMS AND OBJECTIVES: This research was conducted to explore the effectiveness of employing the healthcare failure mode and effect analysis method in the management of trial of labour after caesarean, with the aims of increasing vaginal birth after caesarean section rate and reducing potential risks that might cause severe complications. BACKGROUND: Previously high caesarean section rate in China and the “two children” policy leads to the situation where multiparas are faced with the choice of another caesarean or trial of labour after caesarean. Despite evidences showing the benefits of vaginal birth after caesarean, obstetricians and midwives in China tend to be conservative due to limited experience and insufficient clinical routines. Thus, its management needs further optimisation in order to make the practice safe and sound. DESIGN: A prospective quality improvement programme using the healthcare failure mode and effect analysis. METHODS: With the structured methodology of healthcare failure mode and effect analysis, we determined core processes of antepartum and intrapartum management, conducted risk priority numbers and devised remedial protocols for failure modes with high risks. The programme was then implemented as a clinical routine under the agreement of the institutional review board and vaginal birth after caesarean success rates were compared before and after the quality improvement programme, both descriptively and statistically. Standards for Quality Improvement Reporting Excellence 2.0 checklist was chosen on reporting the study process. RESULTS: Seventy failure modes in seven core processes were identified in the management process, with 14 redressed for actions. The 1‐year follow‐up trial of labour after caesarean and vaginal birth after caesarean rate was increased compared with the previous 3 years, with a vaginal birth after caesarean rate of 86.36%, whereas the incidence of uterine rupture was not compromised. CONCLUSIONS: The application of healthcare failure mode and effect analysis can not only promote trial of labour after caesarean and vaginal birth after caesarean rate, but also maintaining a low risk of uterine rupture. RELEVANCE TO CLINICAL PRACTICE: This modified vaginal birth after caesarean management protocol has been shown effective in increasing its successful rate, which can be continued for further comparison of severe complications to the previous practice.
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spelling pubmed-73287912020-07-02 Using healthcare failure mode and effect analysis as a method of vaginal birth after caesarean section management Liu, Ying Zhu, Wei Le, Shiguan Wu, Wenxian Huang, Qun Cheng, Weiwei J Clin Nurs Original Articles AIMS AND OBJECTIVES: This research was conducted to explore the effectiveness of employing the healthcare failure mode and effect analysis method in the management of trial of labour after caesarean, with the aims of increasing vaginal birth after caesarean section rate and reducing potential risks that might cause severe complications. BACKGROUND: Previously high caesarean section rate in China and the “two children” policy leads to the situation where multiparas are faced with the choice of another caesarean or trial of labour after caesarean. Despite evidences showing the benefits of vaginal birth after caesarean, obstetricians and midwives in China tend to be conservative due to limited experience and insufficient clinical routines. Thus, its management needs further optimisation in order to make the practice safe and sound. DESIGN: A prospective quality improvement programme using the healthcare failure mode and effect analysis. METHODS: With the structured methodology of healthcare failure mode and effect analysis, we determined core processes of antepartum and intrapartum management, conducted risk priority numbers and devised remedial protocols for failure modes with high risks. The programme was then implemented as a clinical routine under the agreement of the institutional review board and vaginal birth after caesarean success rates were compared before and after the quality improvement programme, both descriptively and statistically. Standards for Quality Improvement Reporting Excellence 2.0 checklist was chosen on reporting the study process. RESULTS: Seventy failure modes in seven core processes were identified in the management process, with 14 redressed for actions. The 1‐year follow‐up trial of labour after caesarean and vaginal birth after caesarean rate was increased compared with the previous 3 years, with a vaginal birth after caesarean rate of 86.36%, whereas the incidence of uterine rupture was not compromised. CONCLUSIONS: The application of healthcare failure mode and effect analysis can not only promote trial of labour after caesarean and vaginal birth after caesarean rate, but also maintaining a low risk of uterine rupture. RELEVANCE TO CLINICAL PRACTICE: This modified vaginal birth after caesarean management protocol has been shown effective in increasing its successful rate, which can be continued for further comparison of severe complications to the previous practice. John Wiley and Sons Inc. 2019-10-23 2020-01 /pmc/articles/PMC7328791/ /pubmed/31532033 http://dx.doi.org/10.1111/jocn.15069 Text en © 2019 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Liu, Ying
Zhu, Wei
Le, Shiguan
Wu, Wenxian
Huang, Qun
Cheng, Weiwei
Using healthcare failure mode and effect analysis as a method of vaginal birth after caesarean section management
title Using healthcare failure mode and effect analysis as a method of vaginal birth after caesarean section management
title_full Using healthcare failure mode and effect analysis as a method of vaginal birth after caesarean section management
title_fullStr Using healthcare failure mode and effect analysis as a method of vaginal birth after caesarean section management
title_full_unstemmed Using healthcare failure mode and effect analysis as a method of vaginal birth after caesarean section management
title_short Using healthcare failure mode and effect analysis as a method of vaginal birth after caesarean section management
title_sort using healthcare failure mode and effect analysis as a method of vaginal birth after caesarean section management
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7328791/
https://www.ncbi.nlm.nih.gov/pubmed/31532033
http://dx.doi.org/10.1111/jocn.15069
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