Use of Checklist as a Tool for Prevention of Postpartum Adverse Events
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2014, Vol 2, Issue 6
Abstract
Serious maternal complications like atonic postpartum haemorrhage, inversion of uterus, amniotic fluid embolism and cardiac failure are known to occur in immediate postpartum period. Use of checklist by gynaecology residents to monitor important clinical signs in immediate post partum and post operative period is known to improve vigilance and reduce maternal mortality and morbidity. The objective of the study was to assess the usefulness of checklist in reduction of post partum and post surgical adverse events. This cross sectional study was conducted at a 750-bed tertiary center and teaching hospital. A baseline data of three months duration (historical controls) was collected through document analysis to know the pattern of monitoring of immediate postpartum cases by resident doctors and the incidence and nature of maternal complications. Implementation of a checklist was accomplished following resident and supervisors training over 3 sessions. An end-line data was collected after three months to assess the usefulness of checklist in prevention of postpartum adverse events. The residents completed all checklist sections in 93% of cases. There was significant decrease in adverse events in immediate postpartum and postoperative period .The adverse event rates were 13.60% for historical controls and 3.20% for cases monitored by checklist. There was statistically significant improvement (p value <0.001) in vigilance in monitoring of the postpartum cases. Training of postgraduate students in use of checklist for monitoring of postpartum and postoperative cases brought a sense of accountability in them. The training and checklist adoption was associated with a 4-fold reduction in 5-7-day surgical morbidity among postnatal and surgical cases. Keywords: Post partum haemorrhage, Checklist in obstetrics, Post partum adverse events, Maternal morbidity, Maternal Mortality, Caesarean section.
Authors and Affiliations
Bangal V B. , Patel Menka, Aher Kunal, Tuse Harshad, Singh Shalini
Keywords
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