Mukisa John, Grant Isha, Magala Jonathan, Ssemata Andrew S, Lumala Patrick Z, Byamugisha Josaphat
Uganda CWRU Research Collaboration, Kampala, Uganda.
Department of Child Health, Ministry of Health, Kampala, Uganda.
BMC Health Serv Res. 2019 Feb 7;19(1):107. doi: 10.1186/s12913-019-3934-3.
The appropriate use of the Partograph allows early identification of labour related complications and prevents deaths. We, therefore, sought to determine the level of Partograph completion and healthcare worker perspectives towards its utilization.
This study had two components; a hospital-based cross-sectional descriptive chart review at the Mulago National Referral Hospital, Kampala, Uganda and a qualitative study involving four Focus Group Discussions (FGDs) with ward nurses, midwives and postgraduate residents. Data from the FGDs were analyzed using thematic -content analysis in Open Code software. The quantitative data were summarized using descriptive statistical analysis, means and proportions.
Among the 355 Partographs reviewed, 79.1% had incomplete documentation of age, 52.7% gravidity, and 3.2% parity. In about 61%, the specific parameters for fetal monitoring, maternal monitoring and labour progress were incomplete. From the FGDs, the healthcare workers reported being unable to complete the Partographs due to the overwhelming numbers of expectant mothers and other staff responsibilities. Congestion in the maternity ward reduced the Partograph completion rates. The availability of other monitoring tools, limitation in skills, inadequate equipment and supplies, and the state of the mother at the presentation to the hospital all made Partograph use and completion challenging.
The majority of Partographs started by health workers were incomplete. The time required to document, health system challenges, status of mother at presentation, and the high workload undermined completion of the Partograph at this high volume facility.
正确使用产程图可早期识别与分娩相关的并发症并预防死亡。因此，我们试图确定产程图的填写水平以及医护人员对其使用的看法。
本研究包括两个部分；在乌干达坎帕拉的穆拉戈国家转诊医院进行基于医院的横断面描述性图表审查，以及一项定性研究，涉及与病房护士、助产士和研究生住院医师进行的四次焦点小组讨论（FGD）。使用Open Code软件中的主题内容分析法对FGD的数据进行分析。定量数据使用描述性统计分析、均值和比例进行汇总。
在审查的355份产程图中，79.1%的年龄记录不完整，52.7%的孕次记录不完整，3.2%的产次记录不完整。约61%的胎儿监测、产妇监测和产程进展的具体参数不完整。从FGD中可知，医护人员报告称，由于准妈妈数量众多以及其他工作职责，无法完成产程图的填写。产科病房的拥挤降低了产程图的填写率。其他监测工具的可用性、技能限制、设备和用品不足以及产妇入院时的状况，都使得产程图的使用和填写具有挑战性。
卫生工作者开始填写的大多数产程图不完整。记录所需的时间、卫生系统的挑战、产妇入院时的状况以及高工作量，都影响了这家高流量机构中产程图的填写。
