scholarly journals Reduction in Massive Postpartum Haemorrhage and Red Blood Cell Transfusion During a National Quality Improvement Project, Obstetric Bleeding Strategy for Wales, OBS Cymru: An Observational Study

2020 ◽  
Author(s):  
Sarah Bell ◽  
Rachel Collis ◽  
Philip Pallmann ◽  
Christopher Bailey ◽  
Kathryn James ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Observational Study ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Postpartum Haemorrhage ◽  
Quality Improvement Project ◽  
Red Blood Cell Transfusion ◽  
Improvement Project ◽  
National Quality

scholarly journals Designing and implementing an all Wales postpartum haemorrhage quality improvement project: OBS Cymru (the Obstetric Bleeding Strategy for Wales)

2020 ◽  
Vol 9 (2) ◽  
pp. e000854 ◽  
Author(s):  
Sarah Frances Bell ◽  
Thomas Kitchen ◽  
Miriam John ◽  
Cerys Scarr ◽  
Kevin Kelly ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Quality Improvement ◽  
Blood Loss ◽  
Outcome Measures ◽  
Postpartum Haemorrhage ◽  
Objective Measurement ◽  
Red Blood Cell Transfusion ◽  
National Database ◽  
Improvement Project ◽  
National Quality

BackgroundPostpartum haemorrhage (PPH) contributes to substantial maternal morbidity. Research into PPH has led to improvements in care which have been incorporated into the Obstetric Bleeding Strategy for Wales.InterventionA national quality improvement team supported local teams in implementing multiple interventions including risk assessment, objective measurement of blood loss, multiprofessional assessment (at the bedside at 1000 mL blood loss) and point-of-care (POC) testing of coagulation to guide blood product resuscitation during PPH. The project was rolled out to all 12 obstetric units in 2017. The interventions were reinforced by an All Wales Guideline, PPH proforma and standardised training. A national database, biannual audits, and patient and staff surveys reported process and outcome measures.ResultsProcess measures: during 2017, there was an increase in the percentage of maternities with documented risk assessment (0%–76%), objective measurement of blood loss (52%–88%) and POC testing for coagulation for PPH ≥1500 mL (38%–59%). Maternity staff survey indicated that 94% were aware of the project and 87% stated that it had changed their unit’s management of PPH. Interim outcome measures: the incidence (95% CI) of PPH ≥2500 mL per 1000 maternities in 2017 was 6.03 (5.23–6.95). The annual number of women receiving any red blood cell transfusion, level 3 intensive care admission and hysterectomy for PPH was 19.7 (18.2 to 21.3), 0.702 (0.464 to 1.06) and 0.255 (0.129 to 0.504) per 1000 maternities, respectively.ConclusionsA high level of project awareness across Welsh maternity units has been achieved. Measurement of blood loss was reported to be the most important early change in practice, while PPH documentation and POC testing continue to be embedded. Combining qualitative and quantitative measures to inform implementation has improved project delivery and allowed teams to adapt to local contexts.

Prediction of Escape Red Blood Cell Transfusion in Expectantly Managed Women With Acute Anaemia After Postpartum Haemorrhage

2016 ◽  
Vol 36 (4) ◽  
pp. 204-205
Author(s):  
B.W. Prick ◽  
E. Schuit ◽  
L. Mignini ◽  
A.J.G. Jansen ◽  
D.J. van Rhenen ◽  
...  
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Postpartum Haemorrhage ◽  
Red Blood Cell Transfusion ◽  
Acute Anaemia

Managing Access by Generating Improvements in Cannulation: A national quality improvement project

2020 ◽  
pp. 112972982093933
Author(s):  
Catherine Ann Fielding ◽  
Scott William Oliver ◽  
Alison Swain ◽  
Alayne Gagen ◽  
Sarah Kattenhorn ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Best Practice ◽  
Quality Improvement Project ◽  
Practical Implementation ◽  
Improvement Project ◽  
The United Kingdom ◽  
National Quality ◽  
Arteriovenous Access ◽  
Structure Improvement ◽  
Improvement Method

Cannulation is essential for haemodialysis with arteriovenous access, but also damages the arteriovenous access making it prone to failure, is associated with complications and affects patients’ experiences of haemodialysis. Managing Access by Generating Improvements in Cannulation is a national UK quality improvement project, designed to improve cannulation practice in the United Kingdom, ensuring it reflects current needling recommendations. It uses a simple quality improvement method, the Model for Improvement, to structure improvement to cannulation practice. It assists units in the practical implementation of the British Renal Society and Vascular Access Society of Britain and Ireland needling recommendations, ensuring actual cannulation practice reflects what is defined as best practice in cannulation. An eLearning package and awareness materials have been developed, to assist units in changing their cannulation practice. The Kidney Quality Improvement Partnership provides a structure for Managing Access by Generating Improvements in Cannulation that promotes development and dissemination. It is hoped that Managing Access by Generating Improvements in Cannulation will raise an understanding about the cannulation of arteriovenous access and change behaviours and beliefs around correct cannulation practice, to ensure longevity of this lifeline.

Perioperative Allogeneic Red Blood Cell Transfusion and Wound Infections: An Observational Study

2020 ◽  
Vol 131 (5) ◽  
pp. 1573-1581
Author(s):  
Yuchen Yuan ◽  
Yuelun Zhang ◽  
Le Shen ◽  
Li Xu ◽  
Yuguang Huang
Keyword(s):  
Observational Study ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Red Blood Cell Transfusion ◽  
Wound Infections
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