{"title":"应用质量改进倡议将平均动脉压纳入临床实践。","authors":"Sana Ansari, Reena Yadav, Nishtha Jaiswal, Kanika Chopra, Megha Kansara, Manisha Kumar","doi":"10.1007/s13224-024-02059-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To increase the practice of measuring mean arterial pressure (MAP) in pregnant women during antenatal check-up from 0 to 70% by 6 months.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>The successful incorporation of MAP measurement in routine clinical practice could be done in a busy public hospital using POCQI.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 Suppl 1","pages":"449-456"},"PeriodicalIF":0.7000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085493/pdf/","citationCount":"0","resultStr":"{\"title\":\"Incorporation of Mean Arterial Pressure in Clinical Practice Using Quality Improvement Initiative.\",\"authors\":\"Sana Ansari, Reena Yadav, Nishtha Jaiswal, Kanika Chopra, Megha Kansara, Manisha Kumar\",\"doi\":\"10.1007/s13224-024-02059-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To increase the practice of measuring mean arterial pressure (MAP) in pregnant women during antenatal check-up from 0 to 70% by 6 months.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>The successful incorporation of MAP measurement in routine clinical practice could be done in a busy public hospital using POCQI.</p>\",\"PeriodicalId\":51563,\"journal\":{\"name\":\"Journal of Obstetrics and Gynecology of India\",\"volume\":\"75 Suppl 1\",\"pages\":\"449-456\"},\"PeriodicalIF\":0.7000,\"publicationDate\":\"2025-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085493/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Obstetrics and Gynecology of India\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s13224-024-02059-4\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/10/10 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Obstetrics and Gynecology of India","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s13224-024-02059-4","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/10 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
Incorporation of Mean Arterial Pressure in Clinical Practice Using Quality Improvement Initiative.
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.
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
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