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The OASI care bundle quality improvement project: lessons learned and future direction.

Magdalena Jurczuk1, Posy Bidwell2, Ipek Gurol-Urganci2,3

  • 1Centre for Quality Improvement and Clinical Audit, Royal College of Obstetricians and Gynaecologists, 10-18 Union Street, London, SE1 1SZ, UK. mjurczuk@rcog.org.uk.

International Urogynecology Journal
|May 14, 2021
PubMed
Summary

The OASI Care Bundle, a four-practice intervention, successfully reduced obstetric anal sphincter injury (OASI) rates in a quality improvement project. Further evaluation of this OASI bundle is recommended.

Keywords:
ImplementationOASI Care BundleObstetric anal sphincter injuryQuality improvementScale-upSevere perineal tear

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Area of Science:

  • Obstetrics and Gynecology
  • Quality Improvement Science
  • Patient Safety

Background:

  • Rising rates of obstetric anal sphincter injury (OASI) necessitate evidence-based interventions.
  • The Royal College of Obstetricians and Gynaecologists (RCOG) and Royal College of Midwives (RCM) collaborated to address OASI.
  • The OASI Care Bundle (OASI-CB) was developed to mitigate OASI.

Purpose of the Study:

  • To evaluate the effectiveness of the OASI Care Bundle (OASI-CB) in reducing OASI rates.
  • To identify barriers and enablers to the implementation of the OASI-CB.
  • To summarize findings from the OASI1 quality improvement project and justify further evaluation.

Main Methods:

  • Implementation of the OASI-CB, comprising antenatal discussion, manual perineal protection, mediolateral episiotomy, and postpartum examination.
  • Conducted as a quality improvement (QI) project named 'OASI1' across 16 maternity units in Great Britain.
  • Evaluation focused on OASI rates, implementation barriers, and enablers.

Main Results:

  • The OASI Care Bundle demonstrated a reduction in OASI rates.
  • Key barriers and enablers to the implementation of the OASI-CB were identified.
  • The OASI1 project provided valuable lessons learned for future OASI-CB implementation.

Conclusions:

  • The OASI Care Bundle is a promising intervention for reducing OASI.
  • Understanding implementation facilitators and barriers is crucial for widespread adoption.
  • Further evaluation of the OASI-CB is warranted to optimize its use in clinical practice.