Vol 92, No 5 (2021)
Research paper
Published online: 2021-03-08

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Development of a peer review process to reduce maternal and infant adverse events associated with midwifery

Fang Wang1, Xuan Zhou1, Xin-Fen Xu1
Pubmed: 33751515
Ginekol Pol 2021;92(5):371-377.

Abstract

Objectives: The aim of this study was to establish a midwifery peer review (MPR) process to continuously improve and standardize the midwifery delivery process, thereby reducing maternal and infant adverse events.
Material and methods: First, the MPR committee (MPRC) was established. The co-chairs of our MPRC were the Head of the Nursing Department and the Nursing Director of the Obstetrics Department. Peer review targets included preventing the occurrence of nursing adverse events, improving nursing quality, and optimizing nursing management. We have established a specially digitized case submission system. All cases that met the evaluation criteria formed corresponding midwifery process improvement measures after a discussion at the meeting to continuously improve the level of midwifery.
Results: Between 2014 and 2017, a total of 240 referrals were received by our committee, 211 of which met the criteria for peer review. Our analysis showed that the proportion of adverse events evaluated gradually decreased over time. The percentage of reviewed cases in 2014 was 7.543% of all deliveries (n = 63), which decreased to 6.747% in 2015 (n = 46). The rates in 2016 and 2017 were 5.310% (n = 51) and 5.280% (n = 51), respectively, and the MPRC recommendations resulted in positive practice changes. After reviewing more than 200 cases, the committee recommended the implementation of 20 new rules and regulations through summary and discussion, thus reducing or preventing many problems that are easily ignored during clinical service.
Conclusions: MPR could be an effective tool to improve obstetric quality and midwifery skills. The implementation of MPR promoted a safer environment for mothers and infants and led to a decrease in adverse events related to midwifery.

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References

  1. Kohn LT, Corrigan J, Donaldson MS. To err is human: building a safer health system. Annales Franaises Danesthèsie Et De Rèanimation. 2000; 64.
  2. Murray-Davis B, McDonald H, Cross-Sudworth F, et al. Learning from Adverse Events in Obstetrics: Is a Standardized Computer Tool an Effective Strategy for Root Cause Analysis? J Obstet Gynaecol Can. 2015; 37(8): 728–735.
  3. Aibar L, Rabanaque MJ, Mozas J, et al. Improving patient safety by detecting obstetric care-related adverse events: application of a new screening guide. Arch Gynecol Obstet. 2014; 289(5): 945–952.
  4. O'Neill O. Safe Births: Everybody's Business. Kings Fund 2008.
  5. Padilla-Castillo M, Álvarez-León EE, Aranaz-Andrés JM, et al. Efectos adversos relacionados con la asistencia sanitaria en ginecología y obstetricia: una revisión crítica. Revista de Calidad Asistencial. 2005; 20(2): 90–99.
  6. Kaplan HC, Ballard J. Changing practice to improve patient safety and quality of care in perinatal medicine. Am J Perinatol. 2012; 29(1): 35–42.
  7. Pettker CM. Standardization of intrapartum management and impact on adverse outcomes. Clin Obstet Gynecol. 2011; 54(1): 8–15.
  8. Pettker CM, Thung SF, Norwitz ER, et al. Impact of a comprehensive patient safety strategy on obstetric adverse events. Am J Obstet Gynecol. 2009; 200(5): 492.e1–492.e8.
  9. Bergum SK, Canaan T, Delemos C, et al. Implementation and evaluation of a peer review process for advanced practice nurses in a university hospital setting. J Am Assoc Nurse Pract. 2017; 29(7): 369–374.
  10. Whitney K, Haag-Heitman B, Chisholm M, et al. Nursing Peer Review Perceptions and Practices: A Survey of Chief Nurse Executives. J Nurs Adm. 2016; 46(10): 541–548.
  11. Jepson ZK, Darling CE, Kotkowski KA, et al. Emergency department patient safety incident characterization: an observational analysis of the findings of a standardized peer review process. BMC Emerg Med. 2014; 14: 20.
  12. Jing P, Peifang Z, Meihua Z, et al. Reseacch progress on patients safety and risk control in nursing work. CHINESE NURSING RESEARCH. 2016; 30: 2960–2968.
  13. Shuai Y, Bin Y, YingLan L. The current research state of nursing safety culture. Chinese Nursing Management. 2018; 18: 400–403.
  14. Roberts H, Cronin SN. A Descriptive Study of Nursing Peer-Review Programs in US Magnet® Hospitals. J Nurs Adm. 2017; 47(4): 226–231.
  15. Spiva LA, Jarrell N, Baio P. The power of nursing peer review. J Nurs Adm. 2014; 44(11): 586–590.
  16. American Nurses Association. Peer Review Guidelines Kansas City, 1988.
  17. Fujita LY, Harris MM, Johnson KG, et al. Nursing peer review: integrating a model in a shared governance environment. J Nurs Adm. 2009; 39(12): 524–530.
  18. Branowicki P, Driscoll M, Hickey P, et al. Exemplary professional practice through nurse peer review. J Pediatr Nurs. 2011; 26(2): 128–136.
  19. Gandhi M, Louis FS, Wilson SH, et al. Clinical perspective: creating an effective practice peer review process-a primer. Am J Obstet Gynecol. 2017; 216(3): 244–249.