Reducing Decision to Incision Time Interval for Emergency Cesarean Sections: 24 Months’ Experience from Rural Sierra Leone

Author:

Tucker Lahai,Frühauf Anna,Dumbuya Isata,Muwanguzi Paul,Lado Marta,Lavallie Daniel,Sheku Mohamed,Kachimanga ChiyembekezoORCID

Abstract

Background: This study aimed at describing the changes in the completeness of documentation and changes in decision to incision time interval of emergency cesarean sections after an audit and feedback project a rural hospital in Sierra Leone. Methods: We documented and monitored the decision and incision times for emergency cesarean sections over the course of two years. Year one focused on the introduction of the project and year two focused on the continuous monitoring of the project. We compared the completeness of decision to incision data and used the 30-min benchmark as target for the decision to incision time interval. Results: A total of 762 emergency cesarean sections were included. While the completion of decision time data (72%) did not change between the two reporting periods, documentation of incision time increased from 95% to 98% (p < 0.001). Complete documentation for both decision and incision time was available for 540 (70.9%) emergency cesarean sections. The decision to incision time interval decreased from 105 min to 42 min (p < 0.001). The proportion of cesarean sections started within 30 min increased from 8.5% to 37% (p < 0.001). Conclusion: Although not all cesarean sections were performed within the 30-min threshold, the decision to incision interval decreased significantly. Improvements in documentation and routine reporting of the decision to incision time interval is recommended.

Publisher

MDPI AG

Subject

Health, Toxicology and Mutagenesis,Public Health, Environmental and Occupational Health

Reference24 articles.

1. Sierra Leone Demographic and Health Survey,2014

2. Rapid Assessment of Ebola Impact on Reproductive Health Services and Service Seeking Behavior in Sierra Leone,2016

3. The Impact of the West Africa Ebola Outbreak on Obstetric Health Care in Sierra Leone

4. Ebola and Indirect Effects on Health Service Function in Sierra Leone

5. Sierra Leone National Reproductive, Maternal, Newborn, Child and Adolescent Health Strategy 2017–2021,2017

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