Maternal near miss approach to evaluate quality of care in Alborz province, Iran

23^rd World Nurse Practitioner Conference

September 28-29, 2017 Dubai, UAE

Razieh Lotfi

Alborz University of Medical Sciences, Iran

Scientific Tracks Abstracts: J Nurs Care

Abstract :

Statement of the Problem: The maternal near miss approach has been developed by World Health Organization for assessing and improving the quality of care. This study aimed to examine the incidence, characteristics and features of the care provided for maternal near miss cases in public and private hospitals in Alborz province, Iran. Methodology & Theoretical Orientation: A cross sectional, facility based study was conducted in all 13 public and private hospitals of Alborz province between April 2012 and December 2012. The World Health Organization near miss criteria were applied to gather and analyze the data and indicators related to maternal near miss, access to and quality of maternal care. Findings: 38,715 deliveries were assessed. There were 38,663 live births, 419 (1.08%) had potentially life threatening conditions and 199 had severe maternal outcomes (SMO) (192 near miss cases and 7 maternal deaths). The maternal near miss ratio was 4.97 cases per 1000 live births. The incidence of severe maternal outcome was 5.15 cases per 1000 live births. Severe mortality outcomes index within 12 hours of hospital stay from admission (SMO12) was 3.52%. The proportion of SMO12 cases from the total SMO cases was 99.5%. The Intensive Care Unit (ICU) admission rate among women with SMO was 72.7%, while the overall admission rate was 0.7%. Overall, hypertensive disorder was the most frequent condition among women with potentially life-threatening conditions and maternal near-miss cases. Cardiovascular dysfunction and respiratory dysfunction were the most prevalent dysfunctions among maternal near miss (MNM) cases and maternal death cases respectively. Conclusion & Significance: The WHO maternal near miss criteria help to identify issues that may lead to life threatening conditions and can be used to monitor and improve the quality of care in maternity settings. Hypertensive disorders related to near miss conditions need more attention to prevent maternal severe outcomes in Alborz province.

Biography :

Razieh Lotfi has her expertise in evaluation and passion in improving the maternal health. She has worked in the field of quality assessment of maternal health in some projects common with Ministry of Health and WHO regional office in Iran.