1. Impact of the implementation of the WHO Safe Childbirth Checklist on essential birth practices and adverse events in two Brazilian hospitals: a before and after study
- Author
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Kelienny de Meneses Sousa, Pedro Jesús Saturno-Hernández, Tatyana Maria Silva de Souza Rosendo, Marise Reis de Freitas, Rose L Molina, Wilton Rodrigues Medeiros, Edna Marta Mendes da Silva, and Zenewton André da Silva Gama
- Subjects
Pregnancy ,Infant, Newborn ,Humans ,Female ,General Medicine ,Delivery, Obstetric ,World Health Organization ,Brazil ,Hospitals ,Checklist - Abstract
ObjectiveThe WHO Safe Childbirth Checklist (SCC) is a promising initiative for safety in childbirth care, but the evidence about its impact on clinical outcomes is limited. This study analysed the impact of SCC on essential birth practices (EBPs), obstetric complications and adverse events (AEs) in hospitals of different profiles.DesignQuasi-experimental, time-series study and pre/post intervention.SettingTwo hospitals in North-East Brazil, one at a tertiary level (H1) and another at a secondary level (H2).Participants1440 women and their newborns, excluding those with congenital malformations.InterventionsThe implementation of the SCC involved its cross-cultural adaptation, raising awareness with videos and posters, learning sessions about the SCC and auditing and feedback on adherence indicators.Primary and secondary outcome measuresSimple and composite indicators related to seven EBPs, 3 complications and 10 AEs were monitored for 1 year, every 2 weeks, totalling 1440 observed deliveries.ResultsThe checklist was adopted in 83.3% (n=300) of deliveries in H1 and in 33.6% (n=121) in H2. The hospital with the highest adoption rate for SCC (H1) showed greater adherence to EBPs (improvement of 50.9%;pConclusionsA multifaceted SCC-based intervention can be effective in improving adherence to EBPs and clinical outcomes in childbirth. The context and adherence to the SCC seem to modulate its impact, working better in a hospital of higher complexity.
- Published
- 2022
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