Wamwana E B, Ndavi P M, Gichangi P B, Karanja J G, Muia E G, Jaldesa G W
Pumwani Maternity Hospital, Nairobi, P.O. Box 42849-00100, Nairobi, Kenya.
East Afr Med J. 2007 Jan;84(1):16-23. doi: 10.4314/eamj.v84i1.9486.
To assess the quality of recording critical events in the intrapartum period in Kakamega Provincial General Hospital (PGHK).
Retrospective comparative study.
Provincial General Hospital, Kakamega, the referral hospital for Western Province, Kenya.
Two hundred women admitted at the labour ward during the six-month period between 1st September 2000 and 28th February 2001 were compared to two hundred women admitted between 1st July 2001 and 31st December 2001.
The Safe Motherhood Demonstration Project (SMDP) was introduced in four districts of Western Province, Kenya, in which PGHK is located. It included on job training in Safe Motherhood which emphasised, among others, collection and utilisation of maternal health care services data.
Comprehensiveness of recording of biodata, history taking and examination findings were assessed for women in labour before and during the implementation of the SMDP. The proportion of cases in labour managed by use of partograph and its appropriate use were also determined.
Retrieval rate of patients' notes was 86.9% and 89.6% before and during SMDP respectively. Information on sociodemographic characteristics, history taking, general and obstetric examination had a near universal recording in both groups but data on alcohol consumption, smoking, menarche, previous pregnancies and contraceptive use was poorly recorded. There was a significant improvement in recording of diagnosis and plan of management during the SMDP (p = 0.037). The partograph was used in only 11% of patients before SMDP as compared to 85% during SMDP (p = 0.000). Record on foetal condition and progress of labour were significantly improved during the SMDP (p = 0.000). Records on summary of labour likewise significantly improved during the SMDP (p = 0.02).
The quality of record keeping in the intrapartum period at the PGHK greatly improved during the implementation of the SMDP. It would be worthwhile to assess the sustainability of quality of intrapartum records and care a year or so after the SMDP ended.
评估卡卡梅加省总医院（PGHK）分娩期关键事件的记录质量。
回顾性对比研究。
肯尼亚西部省的转诊医院——卡卡梅加省总医院。
将2000年9月1日至2001年2月28日这六个月期间在产房入院的200名女性与2001年7月1日至12月31日期间入院的200名女性进行比较。
肯尼亚西部省的四个区（PGHK所在地区）引入了安全孕产示范项目（SMDP），其中包括安全孕产在职培训，重点是产妇保健服务数据的收集和利用等。
在SMDP实施前后，对分娩女性的生物数据记录、病史采集和检查结果的全面性进行评估。还确定了使用产程图管理分娩病例的比例及其正确使用情况。
患者病历的检索率在SMDP实施前和实施期间分别为86.9%和89.6%。两组中社会人口学特征、病史采集、全身及产科检查的信息记录几乎都很普遍，但饮酒、吸烟、初潮、既往妊娠和避孕使用的数据记录较差。在SMDP期间，诊断和管理计划的记录有显著改善（p = 0.037）。SMDP实施前仅11%的患者使用产程图，而实施期间为85%（p = 0.000）。SMDP期间胎儿状况和产程进展的记录有显著改善（p = 0.000）。分娩总结记录在SMDP期间同样有显著改善（p = 0.02）。
在SMDP实施期间，PGHK分娩期的记录质量有了很大提高。在SMDP结束一年左右后评估分娩期记录质量和护理的可持续性是值得的。
