methodology 396
TRANSCRIPT
EFFICACY OF AN OBSTETRICALTRIAGE SYSTEM IN LMICs
Evaluation of the ability of a standardized obstetric emergency triage assessment and treatment (ETAT) system to improve documentation of triage assessment — a proxy measure for triage quality — at Cape Coast Teaching Hospital (CCTH) obstetrical unit.
TOTAL372
PRE 118
PREGNANTINTERIM 121
POST 133
POSTPARTUMTOTAL24
PRE 8
INTERIM 8
POST 8
396
1
2
3
4
Results support efficacy of ETAT at CCTH
In pregnancy group, training effective for all
10 History elements
Increased consistency of documentation ofVitals and Plan over time
Greatest improvement after ETAT first implementation
1. Benefit from regular, earlier retraining2. Drop-off because of higher baseline of
triage practices after initial training?
DISCUSSION
METHODOLOGY
pregnancy group
0
20
40
60
80
100
120
NO YES
COU
NTS
REASON FOR REFERRAL
0
20
40
60
80
100
120
NO YES
COU
NTS
GRAVIDITY/PARITY
0
20
40
60
80
100
120
NO YES
COU
NTS
GESTATIONALAGE
0102030405060708090
100
NO YES
COU
NTS
CONTRACTIONPATTERN
0
20
40
60
80
100
120
NO YES
COU
NTS
CERVICALDILATATION
0
10
20
30
40
50
60
70
80
90
NO YES
COU
NTS
VAGINALFLUID LOSS
0
20
40
60
80
100
120
NO YES
COU
NTS
FETAL HEARTRATE
0
20
40
60
80
100
120
NO YES
COU
NTS
FETALMOVEMENT
0
20
40
60
80
100
120
NO YES
COU
NTS
VITALSIGNS
0
20
40
60
80
100
120
NO YES
COU
NTS
PLAN FORCARE
0
1
2
3
4
5
6
7
8
9
NO YES
COU
NTS
GRAVIDITY/PARITY
0
1
2
3
4
5
6
7
8
9
10
NO YES
COU
NTS
GESTATIONAL AGE
0
1
2
3
4
5
6
7
8
9
10
NO YES
COU
NTS
PLAN FOR CARE
0
1
2
3
4
5
6
7
8
9
10
NO YES
COU
NTS
VAGINAL FLUID LOSS
0
1
2
3
4
5
6
7
8
9
10
NO YES
COU
NTS
VITAL SIGNS
Study of women presenting to CCTH obstetrical unit.
Data collected via chart reviews of consecutive women presenting
at three discrete intervals:
Prior to ETAT training (PRE),April – June 2016
After initial ETAT training (INTERIM)October – December 2017
After ETAT re-training (POST)November 2018 – January 2019
postpartum group
one¯way anova Comparison of documentation rate of all history elements
Increased between the PRE and INTERIM periods (p<0.001)
Decreased between the INTERIM and POST periods (p=0.047)
No significant differencebetween the PRE and POST period (p=0.349)
The mean number of elements documented
2
3
4
5
Pre Interim Post
Postpartum
Sum
5.0
5.5
6.0
6.5
7.0
Pre Interim Post Pregnancy
Sum
Legend PREINTERIM
POST
Dr. Lauren Adolph MD, Dr. Richard Pinkrah MD,Dr. David Walawah MD, Dr. Evans Agbeno MD, FWACS, Dr. Betty Anane-Fenin MD, FWACS, Ms. Amewadzi, Ms. Ofori, Janet Slaunwhite, Ms. Merso, Dr. Ronald B. George MD, FRCPC, Dr. Heather Scott MD, FRCSC
Doc
um
enta
tion
Rat
e (M
ean
)
Pregnancy Group Postpartum Group
Doc
um
enta
tion
Rat
e (M
ean
)
Documentation rates of 10 key history elements
were obtained
Mean (95% CI)