Reducing Decision to Incision Time Interval for Emergency Cesarean Sections: 24 Months’ Experience from Rural Sierra Leone

Lahai Tucker, Anna Frühauf, Isata Dumbuya, Paul Muwanguzi, Marta Lado, Daniel Lavallie, Mohamed Sheku and Chiyembekezo Kachimanga
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Lahai Tucker: Partners In Health Sierra Leone, Koidu Town, Kono District, Sierra Leone
Anna Frühauf: Partners In Health Sierra Leone, Koidu Town, Kono District, Sierra Leone
Isata Dumbuya: Partners In Health Sierra Leone, Koidu Town, Kono District, Sierra Leone
Paul Muwanguzi: Partners In Health Sierra Leone, Koidu Town, Kono District, Sierra Leone
Marta Lado: Partners In Health Sierra Leone, Koidu Town, Kono District, Sierra Leone
Daniel Lavallie: Ministry of Health and Sanitation, Koidu Government Hospital, Koidu Town, Kono District, Sierra Leone
Mohamed Sheku: Ministry of Health and Sanitation, Makeni Regional Hospital, Makeni City, Bombali District, Sierra Leone
Chiyembekezo Kachimanga: Partners In Health Sierra Leone, Koidu Town, Kono District, Sierra Leone

IJERPH, 2021, vol. 18, issue 16, 1-10

Abstract: Background: This study aimed at describing the changes in the completeness of documentation and changes in decision to incision time interval of emergency cesarean sections after an audit and feedback project a rural hospital in Sierra Leone. Methods: We documented and monitored the decision and incision times for emergency cesarean sections over the course of two years. Year one focused on the introduction of the project and year two focused on the continuous monitoring of the project. We compared the completeness of decision to incision data and used the 30-min benchmark as target for the decision to incision time interval. Results: A total of 762 emergency cesarean sections were included. While the completion of decision time data (72%) did not change between the two reporting periods, documentation of incision time increased from 95% to 98% ( p < 0.001). Complete documentation for both decision and incision time was available for 540 (70.9%) emergency cesarean sections. The decision to incision time interval decreased from 105 min to 42 min ( p < 0.001). The proportion of cesarean sections started within 30 min increased from 8.5% to 37% ( p < 0.001). Conclusion: Although not all cesarean sections were performed within the 30-min threshold, the decision to incision interval decreased significantly. Improvements in documentation and routine reporting of the decision to incision time interval is recommended.

Keywords: Sierra Leone; cesarean delivery; quality of obstetric care; audit and feedback; decision to incision time interval (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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