Audit on Postnatal Admissions to Maternity Triage in Wishaw General Hospital
Aim:
It goes without saying that the provision of quality postnatal care is an integral part of modern day obstetrics. In the audit which follows we look at the number of postnatal presentations and the factors contributing to these.
Methodology:
All postnatal calls to Maternity Triage at Wishaw General Hospital for a period of three months were analysed retrospectively. From this data set women who went on to be admitted to the department were identified. Retrospective case note analysis was then done for the cohort of postnatal women who required an admission to the department. A pre-set performa was used to capture the data and then analysed over an Excel worksheet.
Result:
Over the three month period, 2.7% of the 4392 Triage calls were for post natal problems. A total of 13 mothers needed admission and an overnight stay in the hospital. Infection was the leading cause for postnatal admissions; while PV bleeds secondary to retained products of conception were the second most prevalent cause. The remaining patients presented with elevated blood pressures, and neonatal problems.
No definite co-relation to age and BMIs were identified. Women with a primi-parity were more frequent presenters. Most admissions were within the first 2 weeks post-partum. The admissions lasted for a day on most occasions. All admissions were reviewed by middle grade clinicians, where as two-thirds of these postnatal women were reviewed by a Consultant during their admissions.
Recommendations:
· There is a need for workforce redistribution to handle the large volume of calls to Maternity Triage.
· Senior review for all post natal attendance was noted and certainly needs to be continued. This will ensure the duration of post natal admissions is kept to a minimum, leading to the least possible disruption in the immediate post natal family life. Consultant reviews for all post natal admissions need to be considered.
· The audit has identified the average number of Post natal admissions in our department and this data has since been used as a bench mark of one of the clinical indicators in our Maternity Dashboard.
· Re-audit in 6 months’ time, to monitor improvement and compliance.