Abstract
Objective: To implement the Modified Obstetric Early Warning System(MOEWS) to promote identification and stabilization of unwell women.
Methods: This before and after study of MOEWS implementation took place between April 2013 and January 2014, in a Government referral hospital in Zimbabwe. After piloting MOEWS, caesarean section case files were retrospectively assessed to ascertain pre-operative stabilization. A longitudinal ‘spot-check’ study, measured the use of MOEWS and action taken on abnormal results. A quality indicator was introduced to assess ongoing implementation. Results were analyzed using chi-squared and logistic regression techniques.
Results: The caesarean section study included 78 women before and 80 after MOEWS implementation. There was a significant improvement in pre-operative stabilization post-intervention(OR 2.78 95% CI 1.39, 5.54). The longitudinal study included 43 women at baseline and 85 post-implementation. A significant improvement was recorded in action taken after MOEWS (1/24(4.17%) vs 28/45(60%) p=0.001). The six-month aggregated quality indicator revealed 78/125(62%) completed MOEWS, with appropriate stabilization in 65/70(92.86%).
Conclusions: Implementation of MOEWS improved women’s care through action being taken on abnormal observations. Before whole-scale adoption of MOEWS in low resource settings, this study should be scaled up and repeated to ensure replicable findings.
Methods: This before and after study of MOEWS implementation took place between April 2013 and January 2014, in a Government referral hospital in Zimbabwe. After piloting MOEWS, caesarean section case files were retrospectively assessed to ascertain pre-operative stabilization. A longitudinal ‘spot-check’ study, measured the use of MOEWS and action taken on abnormal results. A quality indicator was introduced to assess ongoing implementation. Results were analyzed using chi-squared and logistic regression techniques.
Results: The caesarean section study included 78 women before and 80 after MOEWS implementation. There was a significant improvement in pre-operative stabilization post-intervention(OR 2.78 95% CI 1.39, 5.54). The longitudinal study included 43 women at baseline and 85 post-implementation. A significant improvement was recorded in action taken after MOEWS (1/24(4.17%) vs 28/45(60%) p=0.001). The six-month aggregated quality indicator revealed 78/125(62%) completed MOEWS, with appropriate stabilization in 65/70(92.86%).
Conclusions: Implementation of MOEWS improved women’s care through action being taken on abnormal observations. Before whole-scale adoption of MOEWS in low resource settings, this study should be scaled up and repeated to ensure replicable findings.
| Original language | English |
|---|---|
| Pages (from-to) | 175-179 |
| Journal | International Journal of Gynecology & Obstetrics |
| Volume | 136 |
| Issue number | 2 |
| Early online date | 21 Nov 2016 |
| DOIs | |
| Publication status | Published - Feb 2017 |
Keywords
- Decision support tools
- Early Warning Scores
- Recognition of deteriorating patients
- Maternal Health
- Low-resource settings
Access to Document
- Merriel_IJGO
This is the peer reviewed version of the following article: Merriel, A., Murove, B. T., Merriel, S. W.D., Sibanda, T., Moyo, S. and Crofts, J. (2017), Implementation of a modified obstetric early warning system to improve the quality of obstetric care in Zimbabwe. Int J Gynecol Obstet, 136: 175–179. , which has been published in final form at http://dx.doi.org/10.1002/ijgo.12028. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving Eligibility for repository: Checked on 8/12/2016