Robertson Louise, Knight Hannah, Prosser Snelling Edward, Petch Emily, Knight Marian, Cameron Alan, Alfirevic Zarko
Centre for Women's Health Research, University of Liverpool, Liverpool, UK.
Royal College of Obstetricians and Gynaecologists, London, UK.
Semin Fetal Neonatal Med. 2017 Jun;22(3):193-198. doi: 10.1016/j.siny.2017.02.001. Epub 2017 Feb 16.
Although the most recent MBRRACE-UK (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK) perinatal mortality report has shown a downward trend in perinatal mortality, the UK still lags behind the best-performing countries in Europe. The burden of perinatal morbidity and mortality is wide-reaching and devastating for the families and care-providers involved. The aim of the Each Baby Counts (EBC) project is to reduce intrapartum term stillbirths, early neonatal deaths, and severe brain injuries by 50% by 2020. Every maternity care provider has been asked to report their intrapartum term stillbirths, early neonatal deaths and severe brain injuries to the EBC project and provide a copy of the local review. The local reviews are assessed by two trained EBC reviewers in order to establish whether the reviews are of adequate quality. The EBC reviewers are asked independently to assess whether there is sufficient clinical information to make a clinical judgement about care, and whether different care could have had a positive impact on the outcome. The reviewers are asked to indicate in what areas care might be improved. The analysis of the local reports will be twofold. Initially quantitative analysis will provide us with information about the scale of the problem, the quality of the local review process into adverse events, and who is involved in such reviews. Qualitative analysis of the themes highlighted in the reviews will enable us to develop care bundles or other tools to drive local quality improvement.
尽管英国最新的MBRRACE-UK(母婴:通过全英审核与保密调查降低风险)围产期死亡率报告显示围产期死亡率呈下降趋势,但英国在欧洲表现最佳的国家中仍处于落后地位。围产期发病和死亡的负担范围广泛,对相关家庭和护理人员造成了毁灭性影响。“每个婴儿都重要”(EBC)项目的目标是到2020年将产时足月死产、早期新生儿死亡和严重脑损伤减少50%。每个产科护理提供者都被要求向EBC项目报告其产时足月死产、早期新生儿死亡和严重脑损伤情况,并提供一份当地审查报告的副本。当地审查报告由两名经过培训的EBC审查员进行评估,以确定审查质量是否合格。EBC审查员被要求独立评估是否有足够的临床信息来对护理做出临床判断,以及不同的护理措施是否可能对结果产生积极影响。审查员还被要求指出护理可能需要改进的方面。对当地报告的分析将分为两个方面。首先,定量分析将为我们提供有关问题规模、对不良事件的当地审查过程质量以及参与此类审查人员的信息。对审查中突出主题的定性分析将使我们能够制定护理套餐或其他工具,以推动当地质量改进。