Implementing a labor monitoring guideline and midwives responsibilities to increase the completion rate of partograph in Muhima Hospital, Rwanda
Abstract
Purpose
Complete health documentation during childbirth can reduce complications and improve maternal and foetal outcomes. One such document is the partograph which allows health workers to record and follow the labour progress. However, the completion rates of partograph remain low in some hospitals. This study describes the implementation of a quality improvement project to increase the completion rate of partograph in a district hospital in Rwanda.
Design/methodology/approach
The project team tackled the root cause of partograph incompletion by implementing a labour monitoring guideline, assigning patients and duties to midwives and by providing support and supervision.
Findings
The intervention successfully increased overall partograph completion rates from 11 to 61 per cent, p < 0.001. This study also showed that completeness of the partograph was statistically associated with a decrease in foetal deaths and higher Apgar score with p < 0.001 for both.
Practical implications
This study describes the establishment of a quality improvement project following the strategic problem solving approach to increase the completion rate of partograph documentation. The intervention was simple, data-driven and cost-neutral. The team achieved its objectives by integrating staff input, obtaining commitment from the multidisciplinary team and applying leadership skills.
Originality/value
The results are useful for hospitals in limited resources settings wishing to improve overall partograph completion and improve foetal and maternal outcomes during labour, in an efficient and cost-neutral way.
Keywords
Acknowledgements
The authors thank the Ministry of Health for the support of the MHA program. The authors would like to thank all the management of Muhima hospital for supporting this project. They also thank all the staff who participated in this project for their effort and contribution.
Citation
Byukusenge, J.B., Adomako, E., Lukas, S., Mugarura, C., Umucyo, J., Mukagatare, S., Ahishakiye, O., Nyirangondo, C. and Wong, R. (2016), "Implementing a labor monitoring guideline and midwives responsibilities to increase the completion rate of partograph in Muhima Hospital, Rwanda", On the Horizon, Vol. 24 No. 4, pp. 335-340. https://doi.org/10.1108/OTH-07-2016-0036
Publisher
:Emerald Group Publishing Limited
Copyright © 2016, Emerald Group Publishing Limited