Banca de DEFESA: LEILANE DE MELO OLIVEIRA

Patient Safety; Checklist; labor, obstetric.

Introduction: Maternal and neonatal morbidity and mortality are still considered a public health problem at a global level. The qualification of childbirth care is essential to reduce these indicators. One of the means used to standardize and promote good practices is through the Safe Childbirth Checklist (LVPS), benefiting the binomial from hospitalization to hospital discharge. Objective: To evaluate the effectiveness of implementing a cycle to improve adherence to filling out the LVPS in a university hospital. Methodology: This is a quasi-experimental study of the before-after type, without a control group, with a quantitative approach, using an internal quality improvement cycle that seeks to assess the level of quality in adherence to filling out the LVPS, with application of an improvement cycle. The opportunity for improvement was identified through the application of the Nominal Group Technique and Prioritization Matrix, during activities for the preparation of Practical Works (TP) of the Professional Master's in Quality Management in Health Services (Phase 1). This being, the alignment of processes and standardization of the conduct of the multidisciplinary teams in childbirth care. Then, the LVPS was identified as the ideal tool to act on the identified improvement opportunity (Phase 2). Based on this choice, an initial assessment of the quality level of adherence to the filling was carried out (Phase 4) after the definition of the quality criteria (Phase 3), quantifying the global completion of the list per patient (quality criterion 1), filling global per item (quality criterion 2), completion by time of the LVPS (quality criterion 3). From then on, there was the phase of defining intervention proposals (Phase 5), quality improvement intervention (Phase 6) and reassessment of the quality level (Phase 7), with the calculation of the improvement achieved. Result: LVPS was present in 100% of the records at baseline and at reassessment. The quality criteria verified at both times were: C1: the overall filling rate, which was 30% and 65% (p<0.001); C2: fill rate per break point which was: 91.6 and 96.7 at break point 1 (p>0.05), which was 31.6% and 65% at break point 2 (p <0.001), ranged from 30% to 71.6% at break point 3 (p<0.001) and 100% in both assessments. The filling rate per item (C3) was similar to the point at which it is inserted, since in this study there was no incomplete filling of the break points in the sample studied. Conclusion: The hospital studied already had high rates of adherence in relation to break points 1 and 4. The performance of the improvement cycle was effective in increasing adherence to the instrument at times that presented greater quality problems (pause points 2 and 3), which significantly impacted the overall adherence rate. The improvement came from the establishment of new routines in its use, construction of a guidance instrument (SOP) and agreement with the team. Such assets can be used as a model for the implementation or reassessment of the use of LVPS in other services.