Using quality improvement to decrease birth asphyxia rates after 'Helping Babies Breathe' training in Kenya.
Acta Paediatr
; 106(10): 1666-1673, 2017 Oct.
Article
em En
| MEDLINE
| ID: mdl-28580692
ABSTRACT
AIM:
The Helping Babies Breathe (HBB) programme is known to decrease neonatal mortality in low-resource settings but gaps in care still exist. This study describes the use of quality improvement to sustain gains in birth asphyxia-related mortality after HBB.METHODS:
Tenwek Hospital, a rural referral hospital in Kenya, identified high rates of birth asphyxia (BA). They developed a goal to decrease the suspected hypoxic-ischaemic encephalopathy (SHIE) rate by 50% within six months after HBB. Rapid cycles of change were used to test interventions including training, retention and engagement for staff/trainees and improved data collection. Run charts followed the rate over time, and chi-square analysis was used.RESULTS:
Ninety-six providers received HBB from September to November 2014. Over 4000 delivery records were reviewed. Ten months of baseline data showed a median SHIE rate of 14.7/1000 live births (LB) with wide variability. Ten months post-HBB, the SHIE rate decreased by 53% to 7.1/1000 LB (p = 0.01). SHIE rates increased after initial decline; investigation determined that half the trained midwives had been transferred. Presenting data to administration resulted in staff retention. Rates have after remained above goal with narrowing control limits.CONCLUSION:
Focused quality improvement can sustain and advance gains in neonatal outcomes post-HBB training.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Asfixia Neonatal
/
Hipóxia-Isquemia Encefálica
/
Educação Continuada
Tipo de estudo:
Etiology_studies
Limite:
Humans
/
Newborn
País/Região como assunto:
Africa
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article