Patient safety in obstetrics and obstetric anesthesia

Obstetric Safety and Quality at Istishari Arab Hospital: Where Are We Now and How Can We Improve

Background: Indicators for tracking progress in maternal and newborn health have been recommended by a number of global monitoring initiatives. Quality of care is increasingly recognized as an important aspect of maternal and newborn health, particularly in the labor and delivery and immediate postnatal period. Objectives: The purpose of this study is to estimate the frequency of obstetric complications. Furthermore, in 2018, Istishari Arab Hospital assessed the safety and quality of obstetrical procedures. Identifying risk factors that contributed to adverse events in the obstetric department. Methods: A retrospective study is dependent on the use of electronic medical records from inpatient hospitals. Research was conducted in the field of inquiry in an electronic database, as well as related studies. Maternal morbidity and adverse outcomes were identified using diagnosis and procedure codes from the International Classification of Diseases, 10th Revision (ICD-10-CM) within the health information system. Aside from the paper files. SPSS was used for descriptive, univariate, and multivariate analysis. Results This study included 418 women, with 62.2 percent of them having their babies delivered by CS. The average age of the women in this study was 27.84.8 years, with 58.1 percent of them coming from Ramallah. Following a multivariate analysis using logistic regression, our study discovered a positive correlation with P-value 0.05 between educational level and prior CS on one side and surgical site infection on the other. Furthermore, our study found a link between the rate of CS on one side and maternal age, diabetes, hypertension, and gynecological factors on the other (prematurity, multiple gestation). Conclusion: Regardless of the number, patients with a lower education level or a history of CS have a higher risk of surgical site infection and other complications. By focusing on these factors and increasing awareness and education, we may be able to reduce obstetric complications in the future.

Optimal care for mother and child: Safety in obstetric anaesthesia

Anaesthetists play a major role in the perioperative treatment of patients, sharing responsibility for quality and safety in anaesthesia, intensive care, emergency and pain medicine. Several aspects lead to the fact that these issues are particularly important in obstetric anaesthesia. As morbidity and mortality are dramatically higher than in a nonpregnant population in this age, there is room for improvement even in regions with a well-developed healthcare system. Adverse events and complications during birth often hit fast, hard and unexpectedly and require immediate patient-centred care. This mostly involves an interdisciplinary and interprofessional approach that includes obstetricians, neonatologists, anaesthetists, intensivists and of course midwives and nurses. In this article, established standards and emerging possibilities to improve patient safety by developing a culture of awareness for safety aspects, education, establishing safety and communication strategies and performing teamwork- and simulation training are discussed. Apart from these issues, self-care of clinicians is vital in the prevention of adverse events, because fatigue and burnout are associated with increased rates of complications.

Training future anesthesiologists in obstetric care

PURPOSE OF REVIEW

In order for the obstetric anesthesiologist to become a true perioperative / peripartum physician, a change in formative programs and certification process in anesthesia are needed.

RECENT FINDINGS

Anesthesia training programs are migrating to competency based medical education (CBME) worldwide. The traditional model of attending lectures, grand rounds, reading textbooks and journal papers should be complemented by virtual modalities such as massive open online courses or online teaching tools. The gold standard for assessment of procedural skills in anesthesia consists of a combination of global rating scales and previously validated checklists. Behaviors in the perioperative environment not directly related to the use of drugs, equipment or medical expertise are known as anesthesiologist nontechnical skills and trainees must learn and practice these skills; nontechnical skills can determine 50-80% of adverse events in high-risk professions, including medicine. Regular certification programs are also an important component of the new approach in medical education, in some high-income countries, the specialist anesthesiologist is undertaking regular certification but the impact of these programs on overall outcomes is still unknown.

SUMMARY

The obstetric population is becoming a higher risk population, requiring an obstetric anesthesiologist taking on the role of a perioperative / peripartum physician. It is essential that anesthesia training programs migrate to CBME through simulation-based curriculum that allow the achievement of nontechnical skills and team work competencies. It is also essential that regular certification for specialist anesthesiologists occur throughout their entire career.