Centre for Quality Improvement and Clinical Audit, Royal College of Obstetricians and Gynaecologists, 10-18 Union Street, London, SE1 1SZ, UK.
Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
Int Urogynecol J. 2021 Jul;32(7):1989-1995. doi: 10.1007/s00192-021-04786-y. Epub 2021 May 14.
Rising rates of obstetric anal sphincter injury (OASI) led to a collaborative effort by the Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Midwives (RCM) to develop and evaluate the OASI Care Bundle (OASI-CB). The OASI-CB comprises four practices (antenatal discussion about OASI, manual perineal protection, mediolateral episiotomy at 60° from the midline, and systematic examination of the perineum, vagina and ano-rectum after vaginal birth) and was initially implemented as part of a quality improvement (QI) project-"OASI1"-in 16 maternity units across Great Britain. Evaluation of the OASI1 project found that the care bundle reduced OASI rates and identified several barriers and enablers to implementation. This paper summarises the key findings, including strengths, limitations and lessons learned from the OASI1 QI project, and provides rationale for further evaluation of the OASI-CB.
产科肛门括约肌损伤（OASI）发生率上升促使皇家妇产科医师学院（RCOG）和皇家助产士学院（RCM）共同努力，制定并评估产科肛门括约肌损伤护理包（OASI-CB）。OASI-CB 包含四项措施（产前讨论 OASI、会阴手动保护、沿中线 60°作会阴侧切、阴道分娩后系统检查会阴、阴道和肛门直肠），最初作为英国 16 个产科单位质量改进（QI）项目“OASI1”的一部分实施。对 OASI1 项目的评估发现，护理包降低了 OASI 发生率，并确定了实施过程中的几个障碍和促进因素。本文总结了关键发现，包括 OASI1QI 项目的优势、局限性和经验教训，并为进一步评估 OASI-CB 提供了依据。
