| Popis: |
Objectives Preterm birth occurs in 8% of pregnancies in Canada. Administration of antenatal corticosteroids (ANCS) within 7 days of delivery significantly reduces adverse outcomes related to prematurity. This project aims to develop and implement a decision making tool to increase the percentage of infants born prematurely who receive ANCS within 7 days of delivery. Methods Evidence-based Practice for Improving Quality (EPIQ) methods were used to engage a multidisciplinary team to develop an evidence-based decision making tool to guide the administration of ANCS. The tool was implemented on labour and delivery, triage and antepartum wards at a tertiary care centre after educational presentations were offered to Obstetricians, Maternal Fetal Medicine Specialists, NICU, residents and nursing staff and feedback from these stakeholders was incorporated. The Plan-Do-Study-Act (PDSA) cycle was used as a template to evaluate the change in practice. Results PDSA cycles were completed from July 27-August 6, 2020 and October 19-25, 2020. In cycle 1, 66 patients were assessed, with 50% uptake of the tool and 6/11 patients who received ANCS delivered within 7 days of administration. Based on feedback, the data collection process was streamlined in cycle 2, where 23 patients were assessed, the tool was used in 57% of cases and 5/8 patients who received ANCS delivered within 7 days. Conclusions The use of an evidence-based tool was effective in guiding decision making on whether to administer ANCS. Upcoming PDSA cycles will aim to refine the tool and increase uptake to 80%. |
