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Laqshya training

Labour room & ot standardisation

drrabiog
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Laqshya training

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  1. Dr Rabi NarayanSatapathyDepartment of Obst. & GynecologySCB Medical College, Cuttack, Odisha AIIMS : 30 Aug 2019

  2. Our Aim Aim Statement: To function as the apex referral institution in providing quality comprehensive obstetrics and gynecological services to clients in need with a goal to reach zero maternal and neonatal deaths in the institution.

  3. SMART Objectives Objectives to be achieved by September 2019: • 75% of normal deliveries conducted in presence of Birth Companion • 80% normal deliveries conducted using real time Partograph • 100% deliveries conducted in facility where Oxytocin was administered within one minute of birth • 100% normal deliveries conducted using Safe Birth Checklist

  4. Quality Circle formation • Quality circle constituted by office order • Quality circle meets on fixed day (Monday First Week at 12 noon) every month Members of quality circle • Prof. Maya Padhi HOD, O & G • Dr. R. N. Satapathy Asst. Prof O& G • Dr. K.R. Mohapatra Prof. O & G • Dr. Illa Agrawal Asst. Prof. O & G • Dr. R.K. Panigrahi Asst. Prof. O & G • MrsSoumyaMohanty Hospital Manager • MrsSatyabhamaBehera I/C LR OG • MrsSasmita S/N OG O.T. • MrsNirupama S/N OG O.T. • MrsSoudamini I/C LR Store • All Unit Heads (6 Units) Monthly meeting of Quality Circle

  5. Analyzing and measuring quality of care Baseline assessment completed Major gaps • Lack of service providers orientation on quality clinical services • Infection control • Support services • Quality management & Monitoring • Outcome reporting

  6. Analyzing and measuring quality of careReal time partograph

  7. Developing and testing changes% of deliveries where partograph is generated using real-time information 38% Before • Doctors and SNs deployed in LR were not sensitized on importance of partograph for continuous monitoring of labour • Irregular supply of partograph sheets • No monitoring of filling up of partograph After 70%

  8. Analyzing and measuring quality of careRespectful Maternity Care MEASUREMENT

  9. Developing and testing changes% of deliveries are attended by a birth companion (BC) 0% Before • LR staff apprehensive of • overcrowding of LR by presence of BC • possible disturbances by BC in following clinical protocols in the LR • No supply of gowns and masks for BC 50% After

  10. Analyzing and measuring quality of careAMTSL MEASUREMENT

  11. Developing and testing changes% of women administered oxytocin immediately after birth 33% Before • Stock out of oxytocin • No concept of pre-filled syringes • Lack of availability of staff to administer oxytocin immediately after delivery • Staff has inadequate knowledge of AMTSL 100% After

  12. Analyzing and measuring quality of careEssential Newborn Care MEASUREMENT

  13. Developing and testing changes% age of newborn babies breastfed within one hour of delivery 10% Before • LR staff not sensitized on importance of early initiation of breast feeding • Mother and baby were separated immediately after birth for post partum services • NBCC is at a distan from the labour bed • Breastfeeding was initiated only after mother transferred to the ward 60% After

  14. Sustaining improvements

  15. Level specific delegation of action points • Work to be done in the Department of O & G SCB MCH Cuttack. • Post Graduates and staffs to be sensitised how to fill the new maternity bed ticket and take separate consent form for anastheisa. Staffs to be reoriented with supporting monitoring to conduct deliveries under “DAKSHATA” Guidelines. • New projects to be started as per PDCA cycle asses for its sustinence. • Partograph to be done in all cases. • Work to be done by PHD department. • Hand washing area of Maternity O.T and LR are to be newly constructed as per “DAKSHATA” guideline. • Work to be done by PWD department. • Necessary civil works are to be done in maternity OT & LR separate letter will have to be sent to PWD with details of each civil work and repair.  • Works to be done by Sister I/C OT • All junk/ scrap items to be removed from OT. • All necessary Register to be maintained in OT. • Works to be done by Sister I/C LR • All case sheets to be filled in the new maternity tickets. • Mother and baby tag to be made available. • All register to be maintained. • Work to be done by state level. • 500 bedded MCH building

  16. Sustaining improvements cont…. • Improved accountability by improved record keeping • Standardized LR register • Standardized case sheets • Use of safe birth and safe surgery checklist • Consent forms inbuilt in the delivery case sheet Newly designed comprehensive delivery case sheet

  17. Sustaining improvements cont… 2. Signage, Posters and protocols in place for standardized protocols and services

  18. Maternity OT After Before

  19. Sterilization Area After Before

  20. Thank you!

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