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Introduction of Criterion-Based Audit of Postpartum Hemorrhage in a University Hospital in Eastern Ethiopia: Implementation and Considerations

With postpartum hemorrhage (PPH) continuing to be the leading cause of maternal mortality in most low-resource settings, an audit of the quality of care in health facilities is essential. The purpose of this study was to identify areas of substandard care and establish recommendations for the manage...

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Autores principales: Tura, Abera Kenay, Aboul-Ela, Yasmin, Fage, Sagni Girma, Ahmed, Semir Sultan, Scherjon, Sicco, van Roosmalen, Jos, Stekelenburg, Jelle, Zwart, Joost, van den Akker, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7764538/
https://www.ncbi.nlm.nih.gov/pubmed/33322495
http://dx.doi.org/10.3390/ijerph17249281
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author Tura, Abera Kenay
Aboul-Ela, Yasmin
Fage, Sagni Girma
Ahmed, Semir Sultan
Scherjon, Sicco
van Roosmalen, Jos
Stekelenburg, Jelle
Zwart, Joost
van den Akker, Thomas
author_facet Tura, Abera Kenay
Aboul-Ela, Yasmin
Fage, Sagni Girma
Ahmed, Semir Sultan
Scherjon, Sicco
van Roosmalen, Jos
Stekelenburg, Jelle
Zwart, Joost
van den Akker, Thomas
author_sort Tura, Abera Kenay
collection PubMed
description With postpartum hemorrhage (PPH) continuing to be the leading cause of maternal mortality in most low-resource settings, an audit of the quality of care in health facilities is essential. The purpose of this study was to identify areas of substandard care and establish recommendations for the management of PPH in Hiwot Fana Specialized University Hospital, eastern Ethiopia. Using standard criteria (n = 8) adapted to the local hospital setting, we audited 45 women with PPH admitted from August 2018 to March 2019. Four criteria were agreed as being low: IV line-setup (32 women, 71.1%), accurate postpartum vital sign monitoring (23 women, 51.1%), performing typing and cross-matching (22 women, 48.9%), and fluid intake/output chart maintenance (6 women, 13.3%). In only 3 out of 45 women (6.7%), all eight standard criteria were met. Deficiencies in the case of note documentation and clinical monitoring, non-availability of medical resources and blood for transfusion, as well as delays in clinical management were identified. The audit created awareness, resulting in self-reflection of current practice and promoted a sense of responsibility to improve care among hospital staff. Locally appropriate recommendations and an intervention plan based on available resources were formulated.
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spelling pubmed-77645382020-12-27 Introduction of Criterion-Based Audit of Postpartum Hemorrhage in a University Hospital in Eastern Ethiopia: Implementation and Considerations Tura, Abera Kenay Aboul-Ela, Yasmin Fage, Sagni Girma Ahmed, Semir Sultan Scherjon, Sicco van Roosmalen, Jos Stekelenburg, Jelle Zwart, Joost van den Akker, Thomas Int J Environ Res Public Health Article With postpartum hemorrhage (PPH) continuing to be the leading cause of maternal mortality in most low-resource settings, an audit of the quality of care in health facilities is essential. The purpose of this study was to identify areas of substandard care and establish recommendations for the management of PPH in Hiwot Fana Specialized University Hospital, eastern Ethiopia. Using standard criteria (n = 8) adapted to the local hospital setting, we audited 45 women with PPH admitted from August 2018 to March 2019. Four criteria were agreed as being low: IV line-setup (32 women, 71.1%), accurate postpartum vital sign monitoring (23 women, 51.1%), performing typing and cross-matching (22 women, 48.9%), and fluid intake/output chart maintenance (6 women, 13.3%). In only 3 out of 45 women (6.7%), all eight standard criteria were met. Deficiencies in the case of note documentation and clinical monitoring, non-availability of medical resources and blood for transfusion, as well as delays in clinical management were identified. The audit created awareness, resulting in self-reflection of current practice and promoted a sense of responsibility to improve care among hospital staff. Locally appropriate recommendations and an intervention plan based on available resources were formulated. MDPI 2020-12-11 2020-12 /pmc/articles/PMC7764538/ /pubmed/33322495 http://dx.doi.org/10.3390/ijerph17249281 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tura, Abera Kenay
Aboul-Ela, Yasmin
Fage, Sagni Girma
Ahmed, Semir Sultan
Scherjon, Sicco
van Roosmalen, Jos
Stekelenburg, Jelle
Zwart, Joost
van den Akker, Thomas
Introduction of Criterion-Based Audit of Postpartum Hemorrhage in a University Hospital in Eastern Ethiopia: Implementation and Considerations
title Introduction of Criterion-Based Audit of Postpartum Hemorrhage in a University Hospital in Eastern Ethiopia: Implementation and Considerations
title_full Introduction of Criterion-Based Audit of Postpartum Hemorrhage in a University Hospital in Eastern Ethiopia: Implementation and Considerations
title_fullStr Introduction of Criterion-Based Audit of Postpartum Hemorrhage in a University Hospital in Eastern Ethiopia: Implementation and Considerations
title_full_unstemmed Introduction of Criterion-Based Audit of Postpartum Hemorrhage in a University Hospital in Eastern Ethiopia: Implementation and Considerations
title_short Introduction of Criterion-Based Audit of Postpartum Hemorrhage in a University Hospital in Eastern Ethiopia: Implementation and Considerations
title_sort introduction of criterion-based audit of postpartum hemorrhage in a university hospital in eastern ethiopia: implementation and considerations
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7764538/
https://www.ncbi.nlm.nih.gov/pubmed/33322495
http://dx.doi.org/10.3390/ijerph17249281
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