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Classification of the PSP |
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Type of Patient Safety Practice
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Safe
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Clinical Practice (CP)
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Related practices from PaSQ database
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| "Best fit" category of the reported practice |
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Diagnostics
Medication / IV Fluids
There is no specified text here
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| Topic of the reported practice |
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Clinical guidelines or pathways
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Aim and the benefit of the Patient Safety Practice
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Data from literature raise concern about the ever increasing incidence of C-sections. In Italy, both the Ministry of Health and the Regions are paying particular attention to the matter.The incidence of cesarean section has been raising over the last 10 years. The management of labour and delivery is changing and the labour curve described by Freeman are under revaluation. Our aim is to reduce the incidence of cesarean section for dystocia that represent a diagnosis most of the time uncorrected.
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Description of the Patient Safety Practice
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The project enabled to evaluate, through audit methodology and basing on international guidelines, how often and in which way we go against the recommendations in these guidelines in the low-risk nulliparous women group in whom c-section were done because of dystocia. Furthermore, thanks to the introduction of an audit form, we want to analyze whether compliance with international guidelines on management of dystocia may be associated with a reduction in the number of c-sections. The practice is also based on the adoption of a new scheme of infusion of oxytocin by an infusion pump and a procedure that provides at least 4 hours of infusion of oxytocin before formulate the diagnosis of cervical dystocia. Patient and/or citizen associations have not been involved in this phase.
Evaluation process: In the first part of the work has been analyzed the period from 1 January 2009 to 1 February 2010 taking into consideration women undergoing cesarean section for dystocia in cervical in the Unit of Obstetrics and Gynecology of Hospital Carlo Poma in Mantua. In the prospective study which is the second part of the work, the data were obtained via an ad hoc audit scheme whose compilation was carried out by the operators of department from 1 August 2010 to 30 September 2010. In the retrospective study were analyzed 38 folders. In the prospective study were collected 6 cases of dystocia. Data analysis highlighted adhesion to the proposed protocols . The adoption of the cartogram to 4 hours (as proposed by WHO) has reduced the incidence of TC for dystocia (from 37% in 2009 to 31% of the 2010 until September).
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| Attachment of relevant written information and/or photos, as appropriate |
There is no specified text here
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Effectiveness of the Patient Safety Practice
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| Degree of implementation of reported practice |
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Yes, fully
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| Level of implementation of reported practice |
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Unit or ward level
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| Specific and measurable outcome for the reported practice were defined |
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Yes
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| A baseline measurement before implementation of the reported practice was obtained |
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Yes
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| A measurement after full implementation of the reported practice was obtained |
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Yes
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| Evaluation of a "positive" effect of the reported practice on Patient Safety |
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The evaluation showed improvements in Patient Safety outcomes
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| Type of before-and after evaluation |
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Quantitative
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| Enclosure of a reference or attachment in case of published evaluation's results |
There is no specified text here
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Health care context where the Patient Safety Practices was implemented
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Hospital
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Transferability
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| Successful implementation of this Patient Safety Practice in other health care settings than above stated |
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No
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| Specification of implementation in another health care setting(s) |
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There is no specified text here
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| Successful implementation's level of this Patient Safety Practice across settings |
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There is no specified text here
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Involved health care staff
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Physicians
Nurses
Quality manager
Risk manager
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Patient Involvement
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| Direct service user's involvement as integral part of this Patient Safety Practice |
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Yes
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| Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice |
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Patient(s)
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| Point of time in which service user or their reprasentatives' involvement takes place |
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During implementation of the Patient Safety Practices
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| Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice |
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Yes
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| Short description of the service users' level of involvement |
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Consultation, such as asking for information
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| Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users |
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Yes
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| List of sources where public information is accessible |
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http://buonepratiche.agenas.it/practicesdetail.aspx
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Implementation of the Patient Safety Practice
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| Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice |
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No
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| Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc. |
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No
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| List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice |
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There is no specified text here
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| List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice |
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Regular data feed back to involved staff
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| Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice |
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No
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| Description of used incentives, if any. |
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There is no specified text here
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| Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice |
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Yes
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Costs of the Patient Safety Practices
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| Completion of cost calculation related to this Patient Safety Practice |
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No
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| Total number of person days required to implement this Patient Safety Practice |
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
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| Total number of person days required for training as preparation for implementation of this Patient Safety Practice |
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
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| Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice |
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There is no specified text here
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| Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice |
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There is no specified text here
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Contact information
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Name: Marzia Maini, Paolo Zampriolo, Enrico Burato
Country: ITALY
Organisation: A.O. `CARLO POMA` - MANTOVA
E-mail: marzia.maini@aopoma.it
Phone: 0376 201699
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