Evaluating an enhanced quality improvement intervention in maternity units: PReCePT trial protocol

Area of Science:

• Obstetrics and Gynecology
• Neonatal Neurology
• Health Services Research

Background:

• National guidelines recommend magnesium sulfate (MgSO4) for preterm deliveries (<30 weeks gestation) to prevent cerebral palsy.
• Uptake of MgSO4 in eligible women remains suboptimal despite recommendations.
• The PReCePT quality improvement (QI) toolkit was developed to enhance MgSO4 administration.

Purpose of the Study:

• To compare the effectiveness of two implementation strategies for the PReCePT QI toolkit.
• To determine if enhanced support, including funding and microcoaching, improves MgSO4 uptake more than standard support.

Main Methods:

• A cluster randomised controlled trial involving 48 maternity units.
• Units were randomized (2:1) to standard QI toolkit support or enhanced support.
• The primary outcome was MgSO4 uptake in eligible women, assessed over 9 months with a 9-month follow-up.

Main Results:

• The study is ongoing; main results are pending.
• Qualitative interviews and economic evaluations are planned to complement quantitative data.

Conclusions:

• The PReCePT trial will provide crucial data on effective implementation strategies for improving MgSO4 use in preterm birth.
• Findings will inform national efforts to reduce neurological impairments in preterm infants.