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理解产科审计。

Understanding Audit in Obstetrics.

作者信息

Eralil Georgy Joy

机构信息

Department of Obstetrics and Gynaecology, Sreenarayana Institute of Medical Sciences, Chalakka, P.O. North Kuthiyathodu, Ernakulam, Kerala 683594 India.

出版信息

J Obstet Gynaecol India. 2016 Oct;66(Suppl 1):223-8. doi: 10.1007/s13224-016-0840-z. Epub 2016 Feb 26.

Abstract

OBJECTIVE

Aim of this audit is to analyse indication and proportion of babies delivered by elective caesarean section at less than 39(+0) weeks of gestation exposed to antenatal corticosteroids performed in a Premier Hospital, Hywel Dda Health University. The second aim was to learn how an audit can be done and used for improving clinical practice.

METHODS

Present study involved all patients who underwent elective caesarean delivery before 39 weeks completed period of gestation in August and September 2014. Data collected from medical record tracking using ICD-9 codes and analysed by clinical audit department.

EXCLUSION

Patients who underwent elective caesarean section after 39 weeks completed period of gestation.

DISCUSSION

The audit showed 66.6 % of patients were given antenatal corticosteroids. The observation was discussed in consultant meetings, labour forum, and was send as e-mail to every one working in Department of Obstetrics and Gynaecology. The goal was 100 %. Reaudit is to be performed in year time to know the effect of change in practice. All successful audits are structured programmes with realistic aims and objectives, leadership and attitude of senior management, nondirective, hands-on approach, support of staff, strategy groups and regular discussions, emphasis on team working and support, environment conducive to conducting audit.

摘要

目的

本次审核旨在分析在海韦尔·达达健康大学的一家高级医院中,孕周小于39(+0)周时通过择期剖宫产分娩且接受产前糖皮质激素治疗的婴儿的指征和比例。第二个目的是了解如何进行审核并将其用于改善临床实践。

方法

本研究纳入了2014年8月和9月在孕周39周之前接受择期剖宫产的所有患者。通过使用国际疾病分类第九版(ICD-9)编码从病历追踪中收集数据,并由临床审核部门进行分析。

排除标准

孕周39周之后接受择期剖宫产的患者。

讨论

审核显示66.6%的患者接受了产前糖皮质激素治疗。该观察结果在顾问会议、分娩论坛上进行了讨论,并通过电子邮件发送给妇产科的每一位工作人员。目标是100%。将在一年内进行重新审核,以了解实践改变的效果。所有成功的审核都是结构化的项目,具有现实的目标和目的、高级管理层的领导和态度、非指导性的实践方法、工作人员的支持、策略小组和定期讨论、强调团队合作和支持以及有利于进行审核的环境。

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