Original Articles
Quality improvement initiative to improve delayed cord clamping in term normal vaginally delivered babies | |
Dr. Akashjot Kaur, Dr. Ashwani Kumar, Dr. Manmeet Kaur Sodhi, Dr. Charanjit Singh, Dr. Sifatpreet Kaur | |
Introduction: Delayed cord clamping has been the primary method of facilitating placental transfusion. The WHO guideline development group considered this recommendation to be equally important for caesarean sections. Recommendations for the optimal timing of umbilical cord clamping apply equally to preterm and term births. WHO recommends that in newborn babies, who do not require positive- pressure ventilation at birth, the cord should not be clamped earlier than 1 min after birth. Delayed cord clamping (performed approximately 1–3 min after birth) is recommended for all births, while initiating simultaneous essential neonatal care. Quality improvement is defined as combined and unceasing efforts of everyone involved in health care including providers, patients and their families, researchers, planners and administrators to make changes that will lead to better patient outcomes, better health system performance and better professional development. Aims & objectives: To improve rate of delayed cord clamping in term normal vaginally delivered babies by quality improvement methods. To study baseline prevalence of delayed cord clamping in term Normal vaginally delivered babies. To develop a SMART aim for quality improvement which will be specific, measurable, achievable, relevant and timely. Materials & methods: A one year hospital based quality improvement project was carried out in the department of Pediatrics Bebe Nanki Mother and Child Care Center, Amritsar in collaboration with the department of Obstetrics and Gynaecology both affiliated with Government Medical College and Hospital, Amritsar. All neonates delivered by normal vaginal delivery with a gestation of ≥37 weeks were enrolled for study. The babies who required resuscitation at birth and those delivered preterm were excluded from the study. Results: We concluded that using quality improvement methods we were able to improve the rate of delayed cord clamping in our institute from compliance rate of 14% to 42%. Conclusion: A multidisciplinary team including key leadership from the department of Paediatrics, and obstetrics and Gynaecology allowed for the rapid and safe implementation of delayed cord clamping in term normal vaginal delivery. |
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