Improving Obstetrics Surgical Safety in KwaZulu-Natal - Trial PACTR201501000981262

Timeline & Enrollment

Summary

The use of the WHO surgical safety checklist has become a controversial topic with investigators being divided on its use as a safety measure. Anaesthesia and surgery are associated with a 2.5 times greater risk of death in pregnant women in South Africa compared to having a normal vaginal delivery. The effect of a modified WHO surgical safety checklist for maternity care (MSSCL) on surgical outcomes and its use in low and middle income countries (LMIC) is unknown. The aim of the study was to reduce maternal surgical morbidity and mortality in KwaZulu-Natal (KZN) by implementing the MSSCL in maternity operating theatres (OT) in randomly selected district and regional hospitals in KZN. The objectives of the study were to:1. To establish a baseline of the current surgical safety culture in the public sector at 18 randomly selected hospitals in KZN.2. To establish the maternal and neonatal surgical outcomes at these hospitals.3. To implement the MSSCL in 50% (9) of the randomly selected hospitals, comprising 12 district and six regional hospitals.4. To evaluate the effect of the MSSCL on safety attitudes and surgical outcomes5. To compare the safety attitudes and surgical outcomes with hospitals which provide the current standard of care.6. To make recommendations to the KZN Department of Health on implementing, monitoring and evaluating surgical safety practices in the province to reduce the MMR.

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