Quality of vital sign monitoring during obstetric hospitalizations at a regional referral and teaching hospital in Uganda: an opportunity for improvement
INTRODUCTION: Vital sign monitoring is a key component of safe facility-based obstetric care. We aimed to assess quality of care around vital sign monitoring during obstetric hospitalizations in a tertiary-care facility in a resource-limited setting. METHODS: Retrospective review of obstetric record...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
The Pan African Medical Journal
2021-03-01
|
| Series: | The Pan African Medical Journal |
| Subjects: | |
| Online Access: |
https://www.panafrican-med-journal.com/content/article/38/252/pdf/252.pdf
|
| _version_ | 1818917030443614208 |
|---|---|
| author | Godfrey Rwambuka Mugyenyi Joseph Ngonzi Blair Johnson Wylie Jessica Elizabeth Haberer Adeline Adwoa Boatin |
| author_facet | Godfrey Rwambuka Mugyenyi Joseph Ngonzi Blair Johnson Wylie Jessica Elizabeth Haberer Adeline Adwoa Boatin |
| author_sort | Godfrey Rwambuka Mugyenyi |
| collection | DOAJ |
| description | INTRODUCTION: Vital sign monitoring is a key component of safe facility-based obstetric care. We aimed to assess quality of care around vital sign monitoring during obstetric hospitalizations in a tertiary-care facility in a resource-limited setting. METHODS: Retrospective review of obstetric records at a tertiary care facility. We assessed documentation of vital signs including fetal and maternal heart rate, and maternal blood pressure, temperature, oxygen saturation, and urine output. The primary outcome was the quality of vital sign monitoring (high- versus low-quality based on frequency of monitoring). We compared quality of monitoring with timing of admission, presence of complication, and delivery mode using chi-squared tests. RESULTS: Among 360 records of obstetric admissions (94% of a planned random sample), 96% documented a delivery. Of these, 8% of pregnant women and 11% of postpartum women had high-quality vital sign monitoring documented on initial evaluation at admission. For women delivering during the hospitalization, 0.8% of women delivering had high-quality monitoring in the first four hours postpartum, with higher rates of high-quality monitoring in women delivering vaginally compared to those delivered by cesarean (1.4% versus 0%, p=.001). There were no differences in rates of quality monitoring by time of admission, or obstetric complication. CONCLUSION: Very few obstetric hospitalizations had high-quality vital sign monitoring. Attention towards improving vital sign monitoring is a critical need. |
| first_indexed | 2024-12-20T00:27:35Z |
| format | Article |
| id | doaj.art-54fc778a7dde4ec4b95862f136996a11 |
| institution | Directory Open Access Journal |
| issn | 1937-8688 1937-8688 |
| language | English |
| last_indexed | 2024-12-20T00:27:35Z |
| publishDate | 2021-03-01 |
| publisher | The Pan African Medical Journal |
| record_format | Article |
| series | The Pan African Medical Journal |
| spelling | doaj.art-54fc778a7dde4ec4b95862f136996a112022-12-21T20:00:02ZengThe Pan African Medical JournalThe Pan African Medical Journal1937-86881937-86882021-03-013825210.11604/pamj.2021.38.252.2174921749Quality of vital sign monitoring during obstetric hospitalizations at a regional referral and teaching hospital in Uganda: an opportunity for improvementGodfrey Rwambuka Mugyenyi0Joseph Ngonzi1Blair Johnson Wylie2Jessica Elizabeth Haberer3Adeline Adwoa Boatin4 Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, Uganda Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, Uganda Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA Harvard Medical School, Boston, USA Harvard Medical School, Boston, USA INTRODUCTION: Vital sign monitoring is a key component of safe facility-based obstetric care. We aimed to assess quality of care around vital sign monitoring during obstetric hospitalizations in a tertiary-care facility in a resource-limited setting. METHODS: Retrospective review of obstetric records at a tertiary care facility. We assessed documentation of vital signs including fetal and maternal heart rate, and maternal blood pressure, temperature, oxygen saturation, and urine output. The primary outcome was the quality of vital sign monitoring (high- versus low-quality based on frequency of monitoring). We compared quality of monitoring with timing of admission, presence of complication, and delivery mode using chi-squared tests. RESULTS: Among 360 records of obstetric admissions (94% of a planned random sample), 96% documented a delivery. Of these, 8% of pregnant women and 11% of postpartum women had high-quality vital sign monitoring documented on initial evaluation at admission. For women delivering during the hospitalization, 0.8% of women delivering had high-quality monitoring in the first four hours postpartum, with higher rates of high-quality monitoring in women delivering vaginally compared to those delivered by cesarean (1.4% versus 0%, p=.001). There were no differences in rates of quality monitoring by time of admission, or obstetric complication. CONCLUSION: Very few obstetric hospitalizations had high-quality vital sign monitoring. Attention towards improving vital sign monitoring is a critical need. https://www.panafrican-med-journal.com/content/article/38/252/pdf/252.pdf vital sign monitoringlabor and deliverypostpartum carechildbirthquality of care |
| spellingShingle | Godfrey Rwambuka Mugyenyi Joseph Ngonzi Blair Johnson Wylie Jessica Elizabeth Haberer Adeline Adwoa Boatin Quality of vital sign monitoring during obstetric hospitalizations at a regional referral and teaching hospital in Uganda: an opportunity for improvement The Pan African Medical Journal vital sign monitoring labor and delivery postpartum care childbirth quality of care |
| title | Quality of vital sign monitoring during obstetric hospitalizations at a regional referral and teaching hospital in Uganda: an opportunity for improvement |
| title_full | Quality of vital sign monitoring during obstetric hospitalizations at a regional referral and teaching hospital in Uganda: an opportunity for improvement |
| title_fullStr | Quality of vital sign monitoring during obstetric hospitalizations at a regional referral and teaching hospital in Uganda: an opportunity for improvement |
| title_full_unstemmed | Quality of vital sign monitoring during obstetric hospitalizations at a regional referral and teaching hospital in Uganda: an opportunity for improvement |
| title_short | Quality of vital sign monitoring during obstetric hospitalizations at a regional referral and teaching hospital in Uganda: an opportunity for improvement |
| title_sort | quality of vital sign monitoring during obstetric hospitalizations at a regional referral and teaching hospital in uganda an opportunity for improvement |
| topic | vital sign monitoring labor and delivery postpartum care childbirth quality of care |
| url |
https://www.panafrican-med-journal.com/content/article/38/252/pdf/252.pdf
|
| work_keys_str_mv | AT godfreyrwambukamugyenyi qualityofvitalsignmonitoringduringobstetrichospitalizationsataregionalreferralandteachinghospitalinugandaanopportunityforimprovement AT josephngonzi qualityofvitalsignmonitoringduringobstetrichospitalizationsataregionalreferralandteachinghospitalinugandaanopportunityforimprovement AT blairjohnsonwylie qualityofvitalsignmonitoringduringobstetrichospitalizationsataregionalreferralandteachinghospitalinugandaanopportunityforimprovement AT jessicaelizabethhaberer qualityofvitalsignmonitoringduringobstetrichospitalizationsataregionalreferralandteachinghospitalinugandaanopportunityforimprovement AT adelineadwoaboatin qualityofvitalsignmonitoringduringobstetrichospitalizationsataregionalreferralandteachinghospitalinugandaanopportunityforimprovement |