Evaluating adherence to guideline-based quality indicators for postpartum hemorrhage care in the netherlands using video analysis
| Autor: | Sander de Wit, Rosella P.M.G. Hermens, Nico W.E. Schuitemaker, Claudia A. van Meir, Martina Porath, Desiree Moonen-Delarue, Johanna M. Middeldorp, Ben W.J. Mol, R.J. Rijnders, Anneke Dijkman, Paula J.M. Pernet, Jan Molkenboer, Anjoke J.M. Huisjes, Hubertina C.J. Scheepers, Suzan M. de Visser, Helena C. van Vugt, Mallory Woiski, Richard Grol, Martijn A. Oudijk, Leonie van Rheenen-Flach |
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| Přispěvatelé: | Amsterdam Reproduction & Development (AR&D), Obstetrics and Gynaecology, Obstetrie & Gynaecologie, RS: GROW - R4 - Reproductive and Perinatal Medicine, MUMC+: MA Medische Staf Obstetrie Gynaecologie (9) |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
IMPACT Population Video Recording Vital signs MEDLINE PATIENT MORBIDITY 03 medical and health sciences All institutes and research themes of the Radboud University Medical Center 0302 clinical medicine Pregnancy Health care MANAGEMENT Humans Medicine 030212 general & internal medicine education POPULATION REDUCE Netherlands Quality Indicators Health Care education.field_of_study 030219 obstetrics & reproductive medicine business.industry MORTALITY Medical record Other Research Radboud Institute for Health Sciences [Radboudumc 0] Postpartum Hemorrhage Obstetrics and Gynecology Guideline medicine.disease PREVENTION Women's cancers Radboud Institute for Health Sciences [Radboudumc 17] SAFETY Emergency medicine RISK-FACTORS Female Observational study Guideline Adherence business |
| Zdroj: | Obstetrics and gynecology, 132(3), 656-667. Lippincott Williams and Wilkins Obstetrics and Gynecology, 132, 656-667 Obstetrics and Gynecology, 132(3), 656-667. LIPPINCOTT WILLIAMS & WILKINS Obstetrics and Gynecology, 132, 3, pp. 656-667 |
| ISSN: | 0029-7844 |
| Popis: | OBJECTIVE: To assess adherence to the national postpartum hemorrhage guideline and Managing Obstetric Emergencies and Trauma course instructions and its determinants in the Netherlands.METHODS: A prospective observational multicenter study in 16 Dutch hospitals analyzing data from medical records of 398 women at high risk for postpartum hemorrhage, of which 293 were supplemented with data from prospective video recordings. Adherence to guideline-based quality indicators for prevention, management, and organization of postpartum hemorrhage care was measured. Indicators for prevention and management of postpartum hemorrhage were categorized according to the amount of blood loss (less than 500, greater than 500, greater than 1,000, and greater than 2,000 mL).RESULTS: Overall, a lack of adherence was observed, particularly for the actions to be undertaken with blood loss greater than 1,000 mL (69 patients). Actions were not or only taken in a later stage when the blood loss had already increased to greater than 2,000 mL (21 patients). In almost 41% (n=119/293) of the deliveries, no active management was performed, and in almost 80% (n=89/112), vital signs were not monitored (blood loss greater than 500 mL) or monitored too late with respect to blood loss. The video recordings showed that in general the actual care given was considerably underreported in medical records. Postpartum hemorrhage care in the hospitals was well organized. Fifteen hospitals had a local postpartum hemorrhage protocol, and in 12 hospitals, team trainings were organized. Regarding the determinants, high-risk patient identification and type of hospital (university vs nonuniversity hospital) were mostly associated with better adherence.CONCLUSION: This study showed low adherence to the guideline-based quality indicators, indicating a problem with Dutch quality care. The unique video observations provided additional, valuable information at which level improvement can be made. A tailor-made implementation strategy to improve quality of postpartum hemorrhage care has been developed. |
| Databáze: | OpenAIRE |
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