The development of quality indicators for the prevention and management of postpartum haemorrhage in primary midwifery care in the Netherlands

BMC Pregnancy and Childbirth

Jos van Roosmalen¹  Johanna M Middeldorp²  Mallory Woiski³  Susanne IC Sindram²  Marrit Smit² 

[1] Department of Medical Humanities, EMGO Institute VU University Medical Center, van der Boechorststraat 7, Amsterdam, 1081 BT, The Netherlands;Department of Obstetrics, Leiden University Medical Centre, Albinusdreef 2, Leiden, 2300 RC, The Netherlands;Department of Obstetrics, University Medical Centre St Radboud, Geert Grooteplein-Zuid 10, Nijmegen, 6500 HB, the Netherlands

关键词: The Netherlands;    Home birth;    Delphi technique;    Midwifery;    Postpartum haemorrhage;    Quality indicators;   

Others  :  1137794
DOI  :  10.1186/1471-2393-13-194

 received in 2013-06-10, accepted in 2013-10-08,  发布年份 2013

【 摘 要 】

Background

At present, there are no guidelines on prevention and management of postpartum haemorrhage in primary midwifery care in the Netherlands. The first step towards implementing guidelines is the development of a set of quality indicators for prevention and management of postpartum haemorrhage for primary midwifery supervised (home) birth in the Netherlands.

Methods

A RAND modified Delphi procedure was applied. This method consists of five steps: (1) composing an expert panel (2) literature research and collection of possible quality indicators, (3) digital questionnaire, (4) consensus meeting and (5) critical evaluation. A multidisciplinary expert panel consisting of five midwives, seven obstetricians and an ambulance paramedic was assembled after applying pre-specified criteria concerning expertise in various domains relating to primary midwifery care, secondary obstetric care, emergency transportation, maternal morbidity or mortality audit, quality indicator development or clinical guidelines development and representatives of professional organisations.

Results

After literature review, 79 recommendations were selected for assessment by the expert panel. After a digital questionnaire to the expert panel seven indicators were added, resulting in 86 possible indicators. After excluding 41 indicators that panel members unanimously found invalid, 45 possible indicators were assessed at the consensus meeting. During critical evaluation 18 potential indicators were found to be overlapping and two were discarded due to lack of measurability.

Conclusions

A set of 25 quality indicators was considered valid for testing in practice.

【 授权许可】

   
2013 Smit et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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