Successfully reducing newborn asphyxia in the labour unit in a large academic medical centre: a quality improvement project using statistical process control
| Autor: | Louise Munk, Christina Rørbye, Rikke von Benzon Hollesen, Anette Kjaerbye-Thygesen, Rie Laurine Rosenthal Johansen, Pierre M. Barker |
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| Rok vydání: | 2017 |
| Předmět: |
Quality management
Databases Factual Best practice Denmark Decision Making 03 medical and health sciences Patient safety 0302 clinical medicine Pregnancy medicine Humans Cardiotocography 030212 general & internal medicine Obstetrics and Gynecology Department Hospital Asphyxia Patient Care Team Academic Medical Centers Asphyxia Neonatorum 030219 obstetrics & reproductive medicine medicine.diagnostic_test business.industry Health Policy Infant Newborn Theory of change Statistical process control medicine.disease Quality Improvement Apgar Score Female Medical emergency Guideline Adherence medicine.symptom business PDCA Hospital Units Patient Care Bundles |
| Zdroj: | BMJ qualitysafety. 27(8) |
| ISSN: | 2044-5423 |
| Popis: | BackgroundA safe delivery is part of a good start in life, and a continuous focus on preventing harm during delivery is crucial, even in settings with a good safety record. In January 2013, the labour unit at Copenhagen University Hospital, Hvidovre, undertook a quality improvement (QI) project to prevent asphyxia and reduced the percentage of newborns with asphyxia by 48%.MethodsThe change theory consisted of two primary elements: (1) the clinical content, including three clinical bundles of evidence-based care, a ‘delivery bundle’, an ‘oxytocin bundle’ and a ‘vacuum extraction bundle’; (2) an implementation theory, including improving skills in interpretation of cardiotocography, use of QI methods and participation in a national learning network. The Model for Improvement and Deming’s system of profound knowledge were used as a methodological framework. Data on compliance with the care bundles and the number of deliveries between newborns with asphyxia (Apgar ResultsCompliance with all three clinical care bundles improved to 95% or more, and the percentages of newborns with pH ConclusionThis QI project illustrates how aspects of patient safety, such as the prevention of asphyxia, can be improved using QI methods to more reliably implement best practice, even in high-performing systems. |
| Databáze: | OpenAIRE |
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