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

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.