Alderliesten Marianne E, Stronks Karien, Bonsel Gouke J, Smit Bert J, van Campen Maarten M J, van Lith Jan M M, Bleker Otto P
Academic Medical Centre Amsterdam, Department of Obstetrics and Gynaecology, Postbus 22660, 1100 DD Amsterdam, The Netherlands.
Eur J Obstet Gynecol Reprod Biol. 2008 Apr;137(2):141-5. doi: 10.1016/j.ejogrb.2007.06.002.
To describe the experiences of a regional audit of perinatal deaths, including the experiences of the audit members, to discuss similarities and differences with other, existing perinatal audits and to summarize the implications for future implementation.
Perinatal audit with blinded regional auditors. Consecutive cases of perinatal death were analysed for the presence of substandard care. A random selection of cases was reviewed by an external audit panel. The prevalence of substandard care in the Amsterdam audit was compared with other, existing audits. A survey among audit members was executed.
Care providers from all Amsterdam hospitals, as well as general practitioners and independent midwives cooperated. One hundred thirty-seven perinatal deaths were reviewed. In 25% of all perinatal death cases, substandard care factors were present. After 23 completed weeks substandard care factors were present in 35% of cases, and in 52% of intrapartum deaths. These figures are comparable with other, non-regional oriented audits. The review of the external panel was also comparable to the review of the regional audit committee. All audit members felt secure to discuss freely the presence of substandard care.
First systematic experiences with a regional perinatal audit are described. We conclude that a regional perinatal audit is executable. Cooperation of regional care providers is good. Review of substandard care factors is comparable to other, non-regional oriented perinatal audits.
描述围产期死亡区域审计的经验，包括审计成员的经验，讨论与其他现有围产期审计的异同，并总结对未来实施的启示。
由不知情的区域审计人员进行围产期审计。对连续的围产期死亡病例进行分析，以确定是否存在不合格护理。由外部审计小组随机抽取病例进行审查。将阿姆斯特丹审计中不合格护理的发生率与其他现有审计进行比较。对审计成员进行了一项调查。
阿姆斯特丹所有医院的护理人员以及全科医生和独立助产士都进行了合作。审查了137例围产期死亡病例。在所有围产期死亡病例中，25%存在不合格护理因素。在完成23周后，35%的病例存在不合格护理因素，在产时死亡病例中这一比例为52%。这些数字与其他非区域导向的审计结果相当。外部小组的审查也与区域审计委员会的审查相当。所有审计成员都感到可以自由讨论不合格护理的存在。
描述了区域围产期审计的首次系统经验。我们得出结论，区域围产期审计是可行的。区域护理提供者的合作良好。对不合格护理因素的审查与其他非区域导向的围产期审计相当。
