Evaluation of a continuous improvement programme of enhanced recovery after caesarean delivery under neuraxial anaesthesia - 03/01/17
, Nacima Bouhadjari a , Valentina Faitot a , Antoine Mortazavi a , Gilles Kayem b , Laurent Mandelbrot b , Hawa Keita a, c, ⁎ Bienvenue sur EM-consulte, la référence des professionnels de santé.
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Abstract |
Objective |
To assess the performance of a multidisciplinary programme for enhanced recovery after caesarean delivery under neuraxial anaesthesia.
Study design |
Prospective single-centre study.
Methods |
Programme in 6 steps including 3 professional practice audits based on clinical records and questioning patients: audit T0, first “existing state”, creation of a working group, drafting and implementation of a multidisciplinary rehabilitation procedure, second audit (T0+4 months), information about and implementation of corrective measures and a third audit (T0+8 months). Assessment of the performance of the continuous improvement programmes based on six measures comprising the post-caesarean rehabilitation score: duration infusion, early oral analgesia, time to removal of the urinary catheter, time to return to drinking, eating recovery time, use of carbetocin.
Results |
Two hundred and thirty-one patients were included, with 45, 64 and 122 patients at T0, T0+4 months and T0+8 months, respectively. There was a significant increase in patients who received the recovery measures (P<0.0001 for all items) between T0 and T0+8 months: removal of the infusion before 24h (49% versus 93.5%), drinking before 6h (31% versus 55%), eating before 6h (2% versus 38.5%), early oral analgesia before 24h (38% versus 95%), withdrawal of the urinary catheter before 24h (80% versus 95%), use of carbetocin (0% versus 99%).
Conclusion |
Improved practices in rehabilitation after caesarean can be obtained by setting up a multidisciplinary programme as part of a quality approach.
Le texte complet de cet article est disponible en PDF.Keywords : Enhanced recovery, Caesarean delivery, Neuraxial anaesthesia, Audit, Quality process, Multidisciplinary
Plan
Vol 35 - N° 6
P. 395-399 - décembre 2016 Retour au numéro
Article précédent
- Subarachnoid morphine versus TAP blocks for enhanced recovery after caesarean section delivery: A randomized controlled trial
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