Reduction of cesarean delivery rates after implementation of a comprehensive patient safety program

Grünebaum, Amos; Dudenhausen, Joachim W.; Chervenak, Frank A.; Skupski, Daniel

doi:10.1515/jpm-2012-0181

Cited by 17 publications

(7 citation statements)

References 28 publications

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“…Nearly half of the studies originated from the United States (n = 24, 48%) 42,44‐47,50,51,53‐55,59,60,62‐67,69‐74 . The remainder were from the UK (n = 9), 6,35,36,52,58,75‐78 Australia (n = 4), 38,49,79,80 Tanzania (n = 2), 41,81 Canada (n = 2), 37,57 and Brazil (n = 2) 61,68 .…”

Section: Resultsmentioning

confidence: 99%

“…The majority of studies which implemented a clinical governance strategy (n = 27) were classified as a patient safety and quality improvement initiative using the ACSQHC framework (see Table 2a,b). 23 The most frequently reported clinical governance strategy was organization‐led comprehensive patient safety programs (n = 9 studies) 42,51,57,59,60,65‐67,72 . The next most frequent clinical governance strategy was checklists to standardize care (n = 5 studies), 55,56,62,74,82 for example, a surgical checklist to improve safety in obstetric surgery 56 .…”

Section: Resultsmentioning

confidence: 99%

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Organizational strategies to optimize women’s safety during labor and birth: A scoping review

McCormick

Pollock

Kapp

et al. 2021

Birth

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Background Safety is a priority for organizations that provide maternity care, however, preventable harm and errors in maternity care remain. Maternity care is considered a high risk and high litigation area of health care. To mitigate risk and litigation, organizations have implemented strategies to optimize women's safety. Our objectives were to identify the strategies implemented by organizations to optimize women's safety during labor and birth, and to consider how the concept of safety is operationalized to measure and evaluate outcomes of these strategies. Method This scoping review was conducted using the Joanna Briggs Institute Scoping Review Methodology. Published peer‐reviewed literature indexed in CINAHL, Medline, and Embase, databases from 2010 to 2020, were reviewed for inclusion. Fifty studies were included. Data were extracted and thematically analyzed. Results Three categories of organizational strategies were identified to optimize women's safety during labor and birth: clinical governance, models of care, and staff education. Clinical governance programs (n = 30 studies), specifically implementing checklists and audits, models of care, such as midwifery led‐care (n = 11 studies), and staff training programs (n = 9 studies), were predominately for the management of obstetric emergencies. Outcome measures included morbidity and mortality for woman and newborns. Three studies discussed women's perceptions of safety during labor and birth as an outcome measure. Conclusions Organizations utilize a range of strategies to optimize women's safety during labor and birth. The main outcome measure used to evaluate strategies was focused on clinical outcomes for the mother and newborn.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Organizational strategies to optimize women’s safety during labor and birth: A scoping review

McCormick

Pollock

Kapp

et al. 2021

Birth

View full text Add to dashboard Cite

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“…Nor must they undermine the notion that preventable events during labor contribute to adverse outcomes. The creation of less defensive, more demanding classifications of CTG and management that have a physiological/ behavioral underpinning will permit meaningful, evidence-based recommendations for intervention [10,9].…”

Section: Resultsmentioning

confidence: 99%

Litigation related to intrapartum fetal surveillance

Schifrin

Soliman

Koos

2016

Best Practice & Research Clinical Obstetrics & Gynaecol

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“…Studies that have assessed the impact of implementing oxytocin guidelines typically find decreased oxytocin use and improved patient outcomes but report mixed findings as to whether the intervention reduces cesarean birth rates. [41][42][43][44] Most hospitals have an oxytocin guideline to encourage safety and uniformity in practice. These guidelines typically include starting rates, rate and time increments for titrating the medication, and maximum rates.…”

Section: Discussionmentioning

confidence: 99%

“…Another clinical implication is to develop or revise oxytocin administration guidelines. Studies that have assessed the impact of implementing oxytocin guidelines typically find decreased oxytocin use and improved patient outcomes but report mixed findings as to whether the intervention reduces cesarean birth rates 41‐44 …”

Section: Discussionmentioning

confidence: 99%

The Role of Oxytocin in Primary Cesarean Birth Among Low‐Risk Women

Clark

Warren

Shermock

et al. 2020

J Midwife Womens Health

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Introduction To examine whether there is a threshold of oxytocin exposure at which the risk for primary cesarean increases among women who are nulliparous with a term, singleton, vertex fetus (NTSV) and how oxytocin interacts with other risk factors to contribute to this outcome. Methods This was a secondary analysis of the Consortium on Safe Labor data set that used a retrospective cohort study design. Women who met the criteria for NTSV who were not admitted for a prelabor cesarean and for whom oxytocin data were available, were included in the sample. Robust logistic regression was used to examine the association of oxytocin exposure with primary cesarean birth, while controlling for demographic and clinical risk factors and clustering by provider. Results The sample comprised 17,331 women who were exposed to oxytocin during labor. The women were predominantly white non‐Hispanic (59.2%) with an average (SD) gestational age of 39.4 (1.1) weeks and an 18.5% primary cesarean rate. Exposure to greater than 11,400‐milliunits (mU) of oxytocin resulted in 1.6 times increased odds of primary cesarean birth compared with less than 11,400 mU (95% CI 1.01‐2.6). Discussion Exposure to greater than 11,400 mU of oxytocin in labor was associated with an increased odds of primary cesarean birth in NTSV women.

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Reduction of cesarean delivery rates after implementation of a comprehensive patient safety program

Cited by 17 publications

References 28 publications

Organizational strategies to optimize women’s safety during labor and birth: A scoping review

Organizational strategies to optimize women’s safety during labor and birth: A scoping review

Litigation related to intrapartum fetal surveillance

The Role of Oxytocin in Primary Cesarean Birth Among Low‐Risk Women

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