The compliance with a patient-safety bundle for management of placenta accreta spectrum†
| Autor: | Johanna Quist-Nelson, Scott D. Richard, Joanna S. Y. Chan, Vincenzo Berghella, Amanda Roman, Aislinn Crank, Brandon George, Christine H. Kim, Emily A. Oliver, Arbor J. L. Quist |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
030219 obstetrics & reproductive medicine genetic structures Placenta accreta business.industry Cesarean Section Placenta Previa Obstetrics and Gynecology Gestational Age Placenta Accreta medicine.disease Compliance (physiology) 03 medical and health sciences Patient safety 0302 clinical medicine Pregnancy Bundle Pediatrics Perinatology and Child Health medicine Humans Female 030212 general & internal medicine Intensive care medicine business Retrospective Studies |
| DOI: | 10.6084/m9.figshare.9975887 |
| Popis: | Our objective was to evaluate the compliance with a patient-safety bundle for placenta accreta spectrum (PAS) by comparing the implementation of the components of the patient-safety bundle in the pre- and post-protocol time periods as a quality improvement project. This is a before and after retrospective cohort study as a quality improvement report examining compliance with a multidisciplinary delivery approach for patients with suspected PAS between 2007 and 2018. This bundle involved a multidisciplinary approach with maternal-fetal medicine, gynecologic oncology, intervention radiology, obstetric anesthesia, neonatology, and blood bank. The primary outcome was incorporation of all six of the components of the bundle into a PAS procedure: (1) betamethasone, (2) gynecologic oncology intraoperative consult, (3) preoperative balloon catheters, (4) cell salvage technology in the operating room, (5) vertical skin incision, and (6) fundal or high transverse hysterotomy. Demographic, delivery, and patient outcome data were also collected. There were 39 patients included in the study, 17 were pre-protocol and 22 were post-protocol. Patients were more likely to have a PAS suspected in the antenatal period during post protocol period (23.5 versus 90.9%, p p = .003), and receive betamethasone prior to delivery (23.5 versus 86.3%, p p = .001). The primary outcome, adherence to all components of the patient-safety bundle, was more likely to occur in the post protocol period (0 versus 40.9%, p We have successfully implemented a patient-safety bundle for PAS and have standardized the execution of multidisciplinary management for PAS at our institution. |
| Databáze: | OpenAIRE |
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