Delivery of maternal health care in Indigenous primary care services: baseline data for an ongoing quality improvement initiative

Autor: Christine Connors, Tarun Weeramanthri, Ru Kwedza, Alice R. Rumbold, Catherine M. Kennedy, Damin Si, Rhonda Cox, Alex Brown, Michelle Dowden, Lynette R. O'Donoghue, Ross Bailie, Sandra C. Thompson, Helen E. Liddle, Hugh Burke
Přispěvatelé: Rumbold, Alice R, Bailie, Ross S, Si, Damin, Dowden, Michelle C, Kennedy, Catherine M, Cox, Rhonda J, O'Donoghue, Lynette, Liddle, Helen E, Kwedza, Ru K, Thompson, Sandra C, Burke, Hugh P, Brown, Alex DH, Weeramanthri, Tarun, Connors, Christine M
Rok vydání: 2010
Předmět:
Postnatal Care
Adult
Quality management
Native Hawaiian or Other Pacific Islander
Adolescent
pregnancy outcomes
Prenatal care
Documentation
lcsh:Gynecology and obstetrics
Indigenous
03 medical and health sciences
Young Adult
0302 clinical medicine
routine antenatal care
Nursing
Pregnancy
Obstetrics and Gynaecology
Health care
Medicine
Humans
Maternal Health Services
030212 general & internal medicine
lcsh:RG1-991
Quality Indicators
Health Care
Service (business)
Tobacco Use Cessation
Medical Audit
030219 obstetrics & reproductive medicine
Primary Health Care
business.industry
Australia
Obstetrics and Gynecology
Prenatal Care
Sudden infant death syndrome
Middle Aged
Quality Improvement
3. Good health
Cross-Sectional Studies
impact
Female
women
Guideline Adherence
business
Delivery of Health Care
Health care quality
Research Article
Zdroj: BMC Pregnancy and Childbirth
BMC Pregnancy and Childbirth, Vol 11, Iss 1, p 16 (2011)
ISSN: 1471-2393
Popis: Background Australia's Aboriginal and Torres Strait Islander (Indigenous) populations have disproportionately high rates of adverse perinatal outcomes relative to other Australians. Poorer access to good quality maternal health care is a key driver of this disparity. The aim of this study was to describe patterns of delivery of maternity care and service gaps in primary care services in Australian Indigenous communities. Methods We undertook a cross-sectional baseline audit for a quality improvement intervention. Medical records of 535 women from 34 Indigenous community health centres in five regions (Top End of Northern Territory 13, Central Australia 2, Far West New South Wales 6, Western Australia 9, and North Queensland 4) were audited. The main outcome measures included: adherence to recommended protocols and procedures in the antenatal and postnatal periods including: clinical, laboratory and ultrasound investigations; screening for gestational diabetes and Group B Streptococcus; brief intervention/advice on health-related behaviours and risks; and follow up of identified health problems. Results The proportion of women presenting for their first antenatal visit in the first trimester ranged from 34% to 49% between regions; consequently, documentation of care early in pregnancy was poor. Overall, documentation of routine antenatal investigations and brief interventions/advice regarding health behaviours varied, and generally indicated that these services were underutilised. For example, 46% of known smokers received smoking cessation advice/counselling; 52% of all women received antenatal education and 51% had investigation for gestational diabetes. Overall, there was relatively good documentation of follow up of identified problems related to hypertension or diabetes, with over 70% of identified women being referred to a GP/Obstetrician. Conclusion Participating services had both strengths and weaknesses in the delivery of maternal health care. Increasing access to evidence-based screening and health information (most notably around smoking cessation) were consistently identified as opportunities for improvement across services.
Databáze: OpenAIRE
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