Quality of anaesthesia for Caesarean sections: a cross‐sectional study of a university hospital in a low‐income country. Issue 10 (14th July 2015)

• Record Type: Journal Article
• Authors: Eriksson, Jesper; Baker, Tim; Jörnvall, Henrik; Irestedt, Lars; Mulungu, Moses; Larsson, Emma
• Is Part Of: Tropical medicine & international health. Volume 20:Issue 10(2015:Oct.)
• Page Start: 1329
• Page End: 1336
• Publication Date: 2015-07-14
• Subjects: Tropical medicine -- Periodicals; Public health -- Periodicals; 616.988
• DOI: 10.1111/tmi.12553
• Languages: English
• ISSNs: 1360-2276

Abstract

<abstract abstract-type="main" id="tmi12553-abs-0001"> <title>Abstract</title> <sec id="tmi12553-sec-0001" sec-type="section"> <title>Objective</title> <p>To evaluate the quality of anaesthesia for Caesarean sections at Muhimbili National Hospital, Dar es Salaam, Tanzania.</p> </sec> <sec id="tmi12553-sec-0002" sec-type="section"> <title>Method</title> <p>We developed an instrument consisting of 40 quality indicators using an expert group process based on the existing literature. Using the instrument, we observed 50 Caesarean sections. Twenty‐eight of the indicators were structural indicators, such as essential drugs, oxygen supply and anaesthetic equipment. Twelve were process indicators such as evaluation of airway, blood pressure assessment or insertion of an intravenous line.</p> </sec> <sec id="tmi12553-sec-0003" sec-type="section"> <title>Results</title> <p>The median patient age was 28.5 years. A total of 75% (range 61–82%) of the structural indicators were present in the operating theatres, and 55% (range 33–83%) of the process indicators were performed. The neonates' median Apgar score was 9 (range 3–10). Seven babies required ventilation, four babies were stillborn, and all others were alive at follow‐up 2 days after partus. All mothers were alive 2 days post‐surgery.</p> </sec> <sec id="tmi12553-sec-0004" sec-type="section"> <title>Conclusion</title> <p>The low process score suggests that quality improvement initiatives should focus on the processes of anaesthesia for Caesarean sections rather than new drugs and equipment.</p> </sec> </abstract>