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The Leeds University Maternity Audit Project.

B Wilson1, J G Thornton, J Hewison

  • 1Centre for Reproduction Growth and Development, Leeds University, UK.

International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care
|July 11, 2002
PubMed
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UK obstetrics practice significantly improved adherence to evidence-based guidelines between 1988 and 1996. However, many units still require improvement, with preventable complications remaining. Availability of the Cochrane database correlated with better compliance.

Area of Science:

  • Obstetrics and Gynecology
  • Evidence-Based Medicine
  • Healthcare Quality Improvement

Background:

  • Compliance with evidence-based recommendations in UK obstetrics was assessed.
  • Barriers and facilitators to compliance were investigated.

Purpose of the Study:

  • To measure compliance levels and changes in UK obstetrics.
  • To identify factors influencing compliance with evidence-based practices.

Main Methods:

  • Quantitative case-note audit in 1988 and 1996 across 20 UK maternity units.
  • Qualitative interviews with key maternity staff.

Main Results:

  • Significant increases in the use of ventouse (vacuum extractor), polyglycolic acid sutures, maternal steroids for preterm delivery, and antibiotics for Caesarean sections were observed.

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  • No clear relationship was found between unit characteristics (size, facilities, attitudes) and compliance.
  • Availability of the Cochrane database correlated positively with compliance.

    • Conclusions:

    • A substantial shift towards evidence-based practice in UK obstetrics occurred, yet significant room for improvement remains.
    • Preventable complications, including infections and perineal trauma, persist.
    • Local factors and staff commitment, potentially linked to resource availability like the Cochrane database, may influence compliance.