Evaluation of criteria-based clinical audit in improving quality of obstetric care in a developing country hospital.
Study evaluated criteria-based clinical audit in measuring and improving quality of obstetric care for five life-threatening obstetric complications: obstetric haemorrhage, eclampsia, genital tract infections, obstructed labor and uterine rupture. Clinical management of 65 patients was audited using a 'before (Phase I) and after (Phase II)' audit cycle design using standard criteria. Following Phase I, areas in need of improvement were identified; mechanisms for improving quality of care were identified and implemented. Overall care of the complications improved significantly in obstetric haemorrhage (61 to 81%, p = 0.000), eclampsia (54.3 to 90%, p = 0.00), obstructed labour (81.7 to 93.5%, p < 0.001) and genital tract sepsis (66 to 85.2%, p < 0.01). Clinical monitoring, drug use, and urgent attention by senior medial staff also improved significantly after intervention. Criteria-based clinical audit is feasible and acceptable for improving management of life-threatening obstetric complications. Its application is recommended in health institutions in developing countries.
Department of Obstetrics & Gynaecology, Federal Medical Centre, Abeokuta.
K I
KI
Hunyinbo
A O
AO
Fawole
O S
OS
Sotiloye
E O
EO
Otolorin
D000328:Adult; D054869:Clinical Audit; D003906:Developing Countries; D005260:Female; D006801:Humans; D008427:Maternal Health Services / Q000592:standards*; D009549:Nigeria; D009774:Obstetrics / Q000592:standards*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D011446:Prospective Studies; D011787:Quality of Health Care