Abstract
Objective: To create, implement, and evaluate the effectiveness of a cesarean delivery checklist on maternal and neonatal outcomes in a rural African hospital. Methods: Based on input from local authorities, WHO’s Safe Surgical Checklist was modified for cesarean delivery and adapted for use in low-resource settings. Retrospective chart review between April and August 2013 in Kibogora Hospital, Nyamasheke, Rwanda, included the first 100 women undergoing cesarean after checklist implementation and the last 100 women undergoing cesarean before implementation. Checklist utilization was determined and degree of completeness assessed. Outcomes were compared between patients for whom the checklist was utilized and patients for whom the checklist was not utilized, in both pre and post-implementation groups. Results: Checklist utilization rate was 83.0% (83/100). Checklist utilization was associated with significant increases in documentation of estimated blood loss (91.6% [76/83] vs 0.9% [1/117], P<0.001) and antibiotic administration before incision (96.4% [80/83] vs 30.8% [36/117], P<0.001). It was also associated with decreased rates of hospitalization longer than the standard 4 days (19.3% [16/83] vs 70.1% [82/117], P<0.001). Conclusion: Implementation of a cesarean delivery checklist via a culturally specific and resource-specific strategy resulted in high utilization rates and improved performance in key best practices by healthcare providers.
Original language | English (US) |
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Pages (from-to) | 236-241 |
Number of pages | 6 |
Journal | International Journal of Gynecology and Obstetrics |
Volume | 152 |
Issue number | 2 |
DOIs | |
State | Published - Feb 2021 |
Keywords
- Cesarean section checklist
- Maternal morbidity
- Maternal mortality
ASJC Scopus subject areas
- Obstetrics and Gynecology