Increasing adherence to plotting e-partograph: a quality improvement project in a rural maternity hospital in India

Jain, Sonia; Kumar, Praveen; Jain, Manish; Bathla, Megha; Joshi, Shiv H; Srivastava, Sheela; Singh, Mahtab; Sudke, Ajit Kisanrao; Datta, Vikram; Shivkumar, Poonam Varma

doi:10.1136/bmjoq-2021-001404

Cited by 7 publications

(8 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…When we go to a root level and do a PDSA cycle, we don't need multiple studies to find barriers -one study is sufficient as ours. But how to find its solution is mentioned in limited studies [11][12][13], to the best of our literature review. According to Bedwell et al [25] in a realistic review, 'There is a limited description of implementation strategies in the reviewed literature' but our study found the solution to these problems.…”

Section: Discussionmentioning

confidence: 99%

“…We have not used perforated margins as we don't have to refer patients. Another quality improvement study was done by Jain et al in 2022 [13] in a tertiary care centre for using e-partograph. They have also focused on the training, allocation of triage, and assigning responsibility to sisters for filling e-partograph.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have found barriers to its use like lack of time [7], and shortage of staff [7,9,10]. However, only a few studies have been done on quality improvement for use of modified WHO partograph [11][12][13]. Thus, we have done a quality improvement initiative which is an initiative taken to improve the institution-specific processes [14].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Modified WHO Partograph in Labour Room: A Quality Improvement Initiative to Find Out Concerns, Challenges and Solutions

Singh¹,

Agarwal²,

Sinha³

et al. 2022

Cureus

View full text Add to dashboard Cite

Every day many women die in pregnancy and childbirth, most of which are preventable. Regular and timely labour monitoring by partograph is of utmost importance. The aim of this study was to increase partograph use by residents in the Department of Obstetrics and Gynecology in all eligible women from existing 25% to 90% over six months through a quality improvement (QI) process.A team of six members including consultants, residents, and staff nurses did a root cause analysis through fishbone analysis to identify why the rate of use of partograph is only 25% of all cases. Many strategies were implemented through Plan-Do-Study-Act (PDSA) cycles for the cause identified. The interventions were allocation of triage area for timely identification of eligible women in the active phase of labour, training of residents, involving interns and nurses for use in shortage of staff, making departmental written policy, and assigning checking authority, to shift patients with attached partograph only; partograph has to be attached in the file right from the beginning when sisters make women admission file. These were done in five PDSA cycles and the outcome was measured by a control chart. The rate of partograph use increased from 25% to 92% over the study period of six months from September 2020 to February 2021. Regular audits were conducted to maintain the results. It can thus be concluded that partograph appears easy to implement and inexpensive, but its use still has enormous difficulties. But a QI approach can help in improving adherence to partograph use, by solving the root cause of the concern and challenges.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Modified WHO Partograph in Labour Room: A Quality Improvement Initiative to Find Out Concerns, Challenges and Solutions

Singh¹,

Agarwal²,

Sinha³

et al. 2022

Cureus

View full text Add to dashboard Cite

show abstract

“…Pre-identification of high-risk pregnancies to improve triaging at the time of admission and management of complications in labour room: a quality improvement initiative 21 Increasing adherence to plotting e-partograph: a quality improvement project in a rural maternity hospital in India 17 Paediatrics Institution of an antibiotic stewardship programme for rationalizing antibiotic usage: a quality improvement project in the NICU of a public teaching hospital in rural central India 19 Zero neonatal hypothermia around birth…”

Section: Obstetrics and Gynaecologymentioning

confidence: 99%

Creating and sustaining a digital community of practice for quality improvement in South-East Asia during the COVID-19 pandemic

Datta,

Srivastava,

Lalwani

et al. 2023

BMJ Open Qual

Self Cite

View full text Add to dashboard Cite

IntroductionEnsuring quality of care in Low and Middle Income countries (LMICs) is challenging. Despite the implementation of various quality improvement (QI) initiatives in public and private sectors, the sustenance of improvements continues to be a major challenge. A team of healthcare professionals in India developed a digital community of practice (dCoP) focusing on QI which now has global footprints.MethodologyThe dCoP was conceptualised as a multitiered structure and is operational online atwww.nqocncop.orgfrom August 2020 onwards. The platform hosts various activities related to the quality of care, including the development of new products, and involves different cadres of healthcare professionals from primary to tertiary care settings. The platform uses tracking indicators, including the cost of sustaining the dCoP to monitor the performance of the dCoP.ResultSince its launch in 2020, dCoP has conducted over 130 activities using 13 tools with 25 940 registration and 13 681 participants. From April 2021, it has expanded to countries across the South-East Asia region and currently has participants from 53 countries across five continents. It has developed 20 products in four thematic areas for a targeted audience. dCoP is supporting mentoring of healthcare professionals from five countries in the South-East Asia region in their improvement journey. Acquiring new knowledge and improvement in their daily clinical practice has been reported by 93% and 80% of participants, respectively. The dCoP and its partners have facilitated the publication of nearly 40 articles in international journals.ConclusionThis dCoP platform has become a repository of knowledge for healthcare professionals in the South-East Asia region. The current paper summarises the journey of this innovative dCoP in an LMIC setting for a wider global audience.

show abstract

“…Digitizing the partograph improves adherence and overcomes the limitation of paper-based partographs [10,16,[20][21][22]. The electronic partograph is a contemporary instrument for capturing labor data in real time, which can improve mother and infant outcomes [23]. Electronic partographs make it possible to improve the labor management system's record of labor progress statistics and care given to mother and fetus, especially in low-income nations [10,20,24,25].…”

Section: Introductionmentioning

confidence: 99%

Intention to Use Mobile-Based Partograph and Its Predictors Among Obstetric Health Care Providers Working at Public Referral Hospitals in the Oromia Region of Ethiopia in 2022: Cross-Sectional Questionnaire Study

Tilahun,

Adem,

Atinafu

et al. 2024

Online J Public Health Inform

View full text Add to dashboard Cite

Background A partograph is a pictorial representation of the relationship between cervical dilatation and the time used to diagnose prolonged and obstructed labor. However, the utilization of paper-based partograph is low and it is prone to documentation errors, which can be avoided with the use of electronic partographs. There is only limited information on the proportion of intention to use mobile-based partographs and its predictors. Objective The objective of this study was to determine the proportion of obstetric health care providers at public referral hospitals in Oromia, Ethiopia, in 2022 who had the intention to use mobile-based partographs and to determine the predictors of their intention to use mobile-based partographs. Methods We performed an institution-based cross-sectional study from June 1 to July 1, 2022. Census was conducted on 649 participants. A self-administered structured English questionnaire was used, and a 5% pretest was performed. Data were entered into EpiData version 4.6 and exported to SPSS version 25 for descriptive analysis and AMOS (analysis of moment structure; version 23) for structural and measurement model assessment. Descriptive and structural equation modeling analyses were performed. The hypotheses developed based on a modified Technology Acceptance Model were tested using path coefficients and P values <.05. Results About 65.7% (414/630; 95% CI 61.9%-69.4%) of the participants intended to use mobile-based electronic partographs, with a 97% (630/649) response rate. Perceived usefulness had a positive influence on intention to use (β=.184; P=.02) and attitude (β=.521; P=.002). Perceived ease of use had a positive influence on attitude (β=.382; P=.003), perceived usefulness (β=.503; P=.002), and intention to use (β=.369; P=.001). Job relevance had a positive influence on perceived usefulness (β=.408; P=.001) and intention to use (β=.185; P=.008). Attitude positively influenced intention to use (β=.309; P=.002). Subjective norms did not have a significant influence on perceived usefulness (β=.020; P=.61) and intention to use (β=–.066; P=.07). Conclusions Two-thirds of the obstetric health care providers in our study intended to use mobile-based partographs. Perceived usefulness, perceived ease of use, job relevance, and attitude positively and significantly influenced their intention to use mobile-based electronic partographs. The development of a user-friendly mobile-based partograph that meets job and user expectations can enhance the intention to use.

show abstract

Increasing adherence to plotting e-partograph: a quality improvement project in a rural maternity hospital in India

Cited by 7 publications

References 8 publications

Modified WHO Partograph in Labour Room: A Quality Improvement Initiative to Find Out Concerns, Challenges and Solutions

Modified WHO Partograph in Labour Room: A Quality Improvement Initiative to Find Out Concerns, Challenges and Solutions

Creating and sustaining a digital community of practice for quality improvement in South-East Asia during the COVID-19 pandemic

Intention to Use Mobile-Based Partograph and Its Predictors Among Obstetric Health Care Providers Working at Public Referral Hospitals in the Oromia Region of Ethiopia in 2022: Cross-Sectional Questionnaire Study

Contact Info

Product

Resources

About