Evaluating the Impact of Introducing a Two Stage Intrapartum Fetal Monitoring Assessment Using Intermittent Auscultation and Cardiotocography in a Government Hospital, Nagpur, India
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 6,682
- 试验地点
- 1
- 主要终点
- Caesarean section performed for presumed fetal compromise as a prortion of all caesarean sections
研究概览
简要总结
An intrapartum fetal monitoring training programme (on intermittent auscultation and cardiotocography) will be delivered at Government Medical College (GMC) to all relevant staff. This quality improvement project and training evaluation aims to assess and evaluate the impact of this training. This will allow the investigators to understand if it is feasible and acceptable to staff, increases knowledge and improves patient outcomes.
详细描述
As part of Misoprostol or Oxytocin for Labour Induction (MOLI) randomised controlled trial (RCT) (CTRI no. NCT03749902), Government Medical College (GMC) plans to increase the number of cardiotocography (CTG) machines available on labour ward and provide a United Kingdom (UK) based obstetrician to deliver training on cardiotocography (CTG) interpretation in order to improve fetal monitoring for this high risk population.
An intrapartum fetal monitoring training programme (on intermittent auscultation and cardiotocography) will be delivered at Government Medical College (GMC) to all relevant staff. This quality improvement project and training evaluation aims to assess and evaluate the impact of this training. This will allow the investigators to understand if it is feasible and acceptable to staff, increases knowledge and improves patient outcomes. It will be done through staff questionnaires, pre-and-post test scores and by examining the effects on maternal and perinatal outcomes using Kirkpatrick's training evaluation.
The whole project aims:
- To understand current practice and maternal and perinatal outcomes in Government Medical College (GMC)
- To improve intrapartum fetal monitoring with intermittent auscultation and cardiotocography (CTG)
- To improve perinatal morbidity and mortality rates
- To reduce caesarean section rates for presumed fetal compromise
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •All women that deliver within the obstetrics department in Government Medical College (GMC) during the study period (8 months)
- •Exclusion criteria:
- •Deliveries in A&E/medical wards
- •Home deliveries
- •Patients delivered in other hospitals/ambulance deliveries
- •Macerated still birth
- •Fresh still birth with no fetal heart on admission to hospital
排除标准
- 未提供
结局指标
主要结局
Caesarean section performed for presumed fetal compromise as a prortion of all caesarean sections
时间窗: 8 months
Percentage change of rate per month
次要结局
- Intrapartum fetal monitoring - Improved documentation(8 months)
- Intrapartum fetal monitoring - Improved documentation of fetal heart rate(8 months)
- Training - satisfaction and feedback about training(8 months)
- Maternal - Maternal length of hospital stay(8 months)
- Perinatal - Cord blood lactate(8 months)
- Perinatal - Neonatal morbidity(8 months)
- Intrapartum fetal monitoring - Cardiotocography (CTG) meetings(8 months)
- Training - Improvement in pre and post test scores(8 months)
- Maternal - Maternal death(8 months)
- Perinatal - Neonatal intensive care unit (NICU) admission(8 months)
- Intrapartum fetal monitoring - Improved documentation (Risk factors for poor perinatal outcome)(8 months)
- Training - number of staff trained(8 months)
- Maternal - Caesarean section rate overall(8 months)
- Maternal - Operative vaginal delivery rate(8 months)
- Perinatal - Apgar score(8 months)
- Training - Improvement in self perceived knowledge and confidence about intrapartum fetal monitoring(8 months)
- Perinatal - Neonatal resuscitation(8 months)
- Perinatal - Length of NICU stay(8 months)
- Perinatal - Perinatal death before discharge(8 months)
研究者
Andrew D Weeks
Professor of International Maternal Health
University of Liverpool