Audit on management of eclampsia at Sultan Abdul Halim Hospital
- Author:
Mohd Azri Mohd Suan
;
Edahayati Ahmad Tajudin
;
Kunasegaran Kannaiah
- Publication Type:Journal Article
- Keywords:
Eclampsia;
Clinical Audit;
Quality of Care
- MeSH:
Eclampsia;
Clinical Audit
- From:
The Medical Journal of Malaysia
2015;70(3):142-147
- CountryMalaysia
- Language:English
-
Abstract:
SUMMARY
Introduction: Maternal mortality and morbidity from
eclampsia continues to be seen around the globe. Local Key
Performance Index on recurrence of eclamptic fits did not
meet targets, thus this raised the issue whether the care
provided adhered to
the standard management for eclampsia.
Methods: This clinical audit was conducted to assess and
improve the quality of the service being offered to patient,
particularly in managing eclampsia cases. It was conducted
according to the audit cycle. It begins with the development
of 12 standardized criteria for eclampsia management. First
audit was conducted by retrospectively reviewing eclampsia
cases from year 2008 till 2012. Strategies for changes were
formulated and implemented following the results of the first
audit. Second audit was conducted six months after the
changes.
Results: The overall incidence rate of eclampsia was 9.17
per 10,000 deliveries. A first seizure occurred during the
antepartum period in 52.9% of cases (n=27), intrapartum in
24% (n=11) and postpartum in 21% of cases (n=13).
Suboptimal care was mainly on delay of activation of Red
Alert system and no treatment for uncontrolled blood
pressure. Several strategies were implemented, mainly on
improving working knowledge of the staffs and reengineering
hospital Red Alert system. Positive
achievements observed during the second audit, shown by
a reduction in the number of patients with recurrence
eclamptic fits and perinatal mortality rate.
Conclusion: Conducting an audit is essential to evaluate
local performance against the standardized criteria.
Improvement can be achieved with inexpensive solutions
and attainable within a short period of time.
- Full text:P020150904387547154095.pdf
