Background
Methods
Adaptation of the SCC to the Mexican context
Development of indicators
Pilot study for feasibility and reliability
Results
Development of indicators
Monitoring Objective | Type of indicator | Total | ||
---|---|---|---|---|
Structure | Process | Outcome | ||
Factors associated to the SCC implementation | 11 | – | – |
11
|
Utilization of the SCC | – | 4 | – |
4
|
Good practices | 2 | 26 | – |
28
|
Health outcomes | – | – | 10 |
10
|
Total |
13
|
30
|
10
|
53
|
Data source | |
---|---|
A. Indicators potentially associated to the SCC implementation | |
Training on the SCC | |
1. Professionals trained in the use of the SCC | Training records/Questionnaire to health professionals |
2. Professionals trained in the use of the SCC by professional profile | Training records/Questionnaire to health professionals |
Characteristics of the team | |
3. Team size | Log books/Questionnaire to health professionals |
4. Professional profile of team members | Log books/Questionnaire to health professionals |
5. Availability of staff trained in neonatal resuscitation (apply to all shifts) | Questionnaire to health professionals |
6. Composition of the team that attends the childbirth (pre-expulsive stage) | Log books/Observation/Questionnaire to health professionals |
7. Presence of personnel skilled in neonatal resuscitation at birth | Log books/observation/questionnaire to health professionals |
Attitude of health professionals | |
8. Perception of the usefulness of the SCC (not a waste of time) | Questionnaire to health professionals |
9. Perception of the impact of the SCC | Questionnaire to health professionals |
10. Perception of the importance of the SCC implementation for the hospital | Questionnaire to health professionals |
SCC Availability | |
11. Availability of SCC formats when needed | Questionnaire to health professionals |
B. SCC utilization | |
12. Percentage of deliveries with SCC (presence in the medical record) | Medical records |
13. Percentage of deliveries with completed SCC (all items) | SCC present in medical records |
14. Average percentage of SCC completed items (global) | SCC present in medical records |
15. Average percentage of SCC completed items by childbirth stage. | SCC present in medical records |
Indicator description | Prevalence and adjusted bias kappa (PABAK) Pilot test 1 | PABAK Pilot test 2 | |||
---|---|---|---|---|---|
Hospital 1 (n:30) | Hospital 2 (n:17) | Pooled results Hospitals 1 and 2 | Hospital 3 (n:30) | ||
1 | Percentage of women with antibiotic prescribed during the childbirth process | 0.53 | 0.88 | 0.66 | 0.50 |
2 | Percentage of women with antibiotic prescribed during childbirth process antibiotic and it is justified by any symptom | 0.6 | 0.41 | 0.49 |
NF
|
3 | Percentage of newborns who are prescribed antibiotic | 0.67 | 1 | 0.79 | 1 |
4 | Percentage of newborns who are prescribed antibiotic and it is justified by any symptom |
NF
|
NF
|
NF
|
NF
|
5 | Percentage of women who are prescribed magnesium sulfate during the childbirth process | 1 | 1 | 1 | 1 |
6 | Percentage of women who are prescribed magnesium sulfate during the childbirth process and it is justified |
NF
|
NF
|
NF
|
NF
|
7 | Percentage of women with partogram open, including: | 0.38 | 1 | 0.61 | 1 |
• Partograms with name recorded | 0.59 | 1 | 0.74 | 1 | |
• Partograms with age or date of birth recorded | 0.59 | 0.76 | 0.65 | 1 | |
• Partograms with weeks of gestation recorded | 0.59 | 0.76 | 0.65 | 1 | |
8 | Percentage of women with completed partogram, including: | 1 | 1 | 1 | 0.22 |
• Partograms with temperature recorded every 2 h | 0.52 | 0.76 | 0.61 | 0.48 | |
• Partograms with heart rate recorded every 30 min | 0.93 | 1 | 0.96 | 0.13 | |
• Partograms with blood pressure recorded every 4 h | 0.10 | 0.76 | 0.35 | 0.57 | |
• Partograms with registration of vaginal exam or dilation | 0.86 | 0.41 | 0.70 | 0.91 | |
9 | Percentage of women HIV+ with initiation of anti-retroviral treatment |
NF
|
NF
|
NF
|
NF
|
10 | Percentage of women with justified Cesarean delivery |
NF
|
NF
|
NF
| 0.83 |
11 | Percentage of women with justified instrumental delivery |
NF
|
NF
|
NF
|
NF
|
12 | Percentage of women with justified episiotomy | 0.92 |
NF
| 0.92 | 0.90 |
13 | Percentage of women with adequate management of the 3rd period of delivery, including: | 0.87 | 1 | 0.96 | 0.78 |
• Deliveries with oxytocin administered in the first minute | 0.33 | 0.29 | 0.32 | 0.43 | |
• Births with traction of the umbilical cord to extract the placenta | 0.20 | −0.88 | −0.17 | 0.85 | |
• Uterine massage is performed after removing the placenta | 0.87 | 0.88 | 0.87 | 0.93 | |
14 | Percentage of deliveries in which the presence of a second baby is checked and disconfirmed | 0.20 | 0.65 | 0.36 | 1 |
15 | Percentage of women with adequate management of postpartum hemorrhage |
NF
|
NF
|
NF
|
NF
|
16 | Percentage of newborns with adequate immediate care, including: | 0.72 | 0.88 | 0.82 | 0.73 |
• Drying and kept warm | 0.24 | 0.76 | 0.43 | 0.73 | |
• Administration of vitamin K | 0.71 | 1 | 0.82 | 1 | |
• Administration of ophthalmic prophylaxis | 0.86 | 0.88 | 0.87 | 0.8 | |
17 | Percentage of newborns with late clamping of umbilical cord | 0.87 | 0.53 | 0.74 | 1 |
18 | Percentage of newborns with immediate skin to skin contact | 0.72 | 0.06 | 0.48 | 1 |
19 | Percentage of newborns with HIV+ mothers and anti-retroviral treatment initiated |
NF
|
NF
|
NF
|
NF
|
20 | Percentage of women with hemorrhage | 0.87 | 0.88 | 0.87 | 0.93 |
21 | Percentage of women with blood pressure disorders | 0.93 | 0.88 | 0.91 | 0.93 |
22 | Percentage of women with post-partum or perinatal infection | 0.87 | 1 | 0.91 | 0.71 |
23 | Percentage of infants with neonatal infection | 0.8 | 1 | 0.87 | 1 |
24 | Percentage of infants with neonatal asphyxia | 0.93 | 1 | 0.96 | 0.87 |
25 | Percentage of women with Cesarean delivery | 1 | 1 | 1 | 1 |
26 | Percentage of women with instrumental delivery | 1 | 1 | 1 | 1 |
27 | Percentage of women with episiotomy at childbirth | 1 | 1 | 1 | 0.88 |
28 | Percentage of deliveries with adverse events in women | 0.8 | 0.88 | 0.83 | 1 |
29 | Percentage of deliveries with adverse events in newborns | 1 | 1 | 1 | 0.60 |
Indicator description | Type of indicator | Data source | |
---|---|---|---|
1 | Percentage of women whose partner is informed and encouraged to be present at the birth | Process | Questionnaire to mothers |
2a | Frequency of availability of inputs for attention to the mother immediately before childbirth | Structure | Questionnaire to health professionals |
3a | Frequency of availability of inputs for care of the newborn immediately after childbirth | Structure | |
4b | Percentage of newborns with immediate skin to skin contact | Process | Questionnaire to mothers |
5b | Percentage of newborns starting breastfeeding right after birth | Process | |
6 | Percentage of women informed about family planning before discharge | Process | |
7 | Percentage of women and/or partners informed about the mother warning signs to ask for help | Process | |
8 | Percentage of women who know at discharge the visits that must be made (them and the newborn) and the place to turn to revisions | Process | |
9 | Percentage of women and/or partners informed about the warning signs of the newborn to ask for help | Process |