Incorporation of Mean Arterial Pressure in Clinical Practice Using Quality Improvement Initiative.

IF 0.7 Q4 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynecology of India Pub Date : 2025-04-01 Epub Date: 2024-10-10 DOI:10.1007/s13224-024-02059-4

Sana Ansari, Reena Yadav, Nishtha Jaiswal, Kanika Chopra, Megha Kansara, Manisha Kumar

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引用次数: 0

Abstract

Objectives: To increase the practice of measuring mean arterial pressure (MAP) in pregnant women during antenatal check-up from 0 to 70% by 6 months.

Methods: A quality improvement (QI) team ran multiple Plan-Do-Study-Act (PDSA) cycles. The process measure was two weekly assessments of improvement in MAP measurement. The outcome measure was the proportion of women started on aspirin. The pregnancy outcome of the low-risk and high-risk women were compared.

Results: A total of 360 antenatal women were evaluated. With successive PDSA cycles, which included bridging knowledge gaps; involvement of a multidisciplinary team; involvement of supporting staff; application of software, the MAP measurement improved from 0 to 90% by the end of the study. Total 120/360 (33.3%) cases were deemed high risk based on the presence of maternal risk factors (OR -7.2 , C/I 1.43-36.50). The sensitivity, specificity, PPV and NPV of the test was 75.0%, 70.4%, 5.7%, 99.2% respectively. Total 14/120 (11.7%) cases at high risk of PE were started on aspirin. PE occurred in 6/106 (7.6%) women who were not on aspirin.

Conclusion: The successful incorporation of MAP measurement in routine clinical practice could be done in a busy public hospital using POCQI.

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应用质量改进倡议将平均动脉压纳入临床实践。

目的：提高孕妇在产前检查中测量平均动脉压（MAP）的比例，从0提高到6个月时的70%。方法：一个质量改进（QI）团队运行多个计划-执行-研究-行动（PDSA）循环。过程测量是每周两次对MAP测量改进的评估。结果测量是开始服用阿司匹林的女性比例。比较低危和高危妇女的妊娠结局。结果：共对360例产前妇女进行了评估。通过连续的PDSA循环，其中包括弥合知识差距；多学科团队的参与；辅助人员的参与；通过软件的应用，研究结束时MAP测量从0提高到90%。根据母体危险因素的存在，120/360例（33.3%）被认为是高危病例（OR -7.2, C/I 1.43-36.50）。检测灵敏度75.0%，特异度70.4%,PPV 5.7%, NPV 99.2%。120例PE高危患者中有14例（11.7%）开始服用阿司匹林。未服用阿司匹林的女性中PE发生率为6/106（7.6%）。结论：在繁忙的公立医院，应用POCQI可以成功地将MAP测量纳入常规临床实践。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Obstetrics and Gynecology of India OBSTETRICS & GYNECOLOGY-

CiteScore

1.30

自引率

0.00%

发文量

124

期刊介绍： Journal of Obstetrics and Gynecology of India (JOGI) is the official journal of the Federation of Obstetrics and Gynecology Societies of India (FOGSI). This is a peer- reviewed journal and features articles pertaining to the field of obstetrics and gynecology. The Journal is published six times a year on a bimonthly basis. Articles contributed by clinicians involved in patient care and research, and basic science researchers are considered. It publishes clinical and basic research of all aspects of obstetrics and gynecology, community obstetrics and family welfare and subspecialty subjects including gynecological endoscopy, infertility, oncology and ultrasonography, provided they have scientific merit and represent an important advance in knowledge. The journal believes in diversity and welcomes and encourages relevant contributions from world over. The types of articles published are: · Original Article· Case Report · Instrumentation and Techniques · Short Commentary · Correspondence (Letter to the Editor) · Pictorial Essay