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Background: Documentation is crucial for evidence-based nursing. Proper documentation ensures effective communication and quality patient care, while poor documentation compromises care. This study compared structural and process factors affecting documentation quality and patient outcomes in private and public labor wards at Parirenyatwa Mbuya Nehanda Maternity Hospital (MNMH). Methods: A multiple methods approach was used. A total of 177 records were assessed for quality documentation, and 10 midwives were observed on practice documentation. Additionally, 116 interviews were conducted with midwives to elicit information on documentation practices. Data was collected and quantitative data was analyzed using Statistical Package for Social Sciences version (SPSS version 20). Qualitative data was manually analysed and thematic analysis was used to generate codes and themes. Quantitative data was presented in tables, graphs, as frequencies and percentages while qualitative data was presented in narrative form. Results: With regards to structural factors, being in a public labour ward was significantly associated with increased the likelihood of higher nurse to patient ratio compared to being in a private labour ward (p=0.002). No process indicator was significantly associated with the type of labour. Those in the public labour ward were more likely to have complications and admitted in (Neonatal Intensive Care Unit) NICU (p=0.008). Conclusion: The study determined that there was poor documentation practice in both public and private labour wards. Though there was a high level of awareness of critical aspects of labour to document and the importance of documentation by midwives from both wards, this did not necessarily translate to practice. There is a need to also formulate standard operating protocols and guidelines to guide and standardize documentation at MNMH.
Background: Documentation is crucial for evidence-based nursing. Proper documentation ensures effective communication and quality patient care, while poor documentation compromises care. This study compared structural and process factors affecting documentation quality and patient outcomes in private and public labor wards at Parirenyatwa Mbuya Nehanda Maternity Hospital (MNMH). Methods: A multiple methods approach was used. A total of 177 records were assessed for quality documentation, and 10 midwives were observed on practice documentation. Additionally, 116 interviews were conducted with midwives to elicit information on documentation practices. Data was collected and quantitative data was analyzed using Statistical Package for Social Sciences version (SPSS version 20). Qualitative data was manually analysed and thematic analysis was used to generate codes and themes. Quantitative data was presented in tables, graphs, as frequencies and percentages while qualitative data was presented in narrative form. Results: With regards to structural factors, being in a public labour ward was significantly associated with increased the likelihood of higher nurse to patient ratio compared to being in a private labour ward (p=0.002). No process indicator was significantly associated with the type of labour. Those in the public labour ward were more likely to have complications and admitted in (Neonatal Intensive Care Unit) NICU (p=0.008). Conclusion: The study determined that there was poor documentation practice in both public and private labour wards. Though there was a high level of awareness of critical aspects of labour to document and the importance of documentation by midwives from both wards, this did not necessarily translate to practice. There is a need to also formulate standard operating protocols and guidelines to guide and standardize documentation at MNMH.
BACKGROUND: The goal of natural childbirth care is to have a healthy mother and baby with minimal interventions that are contrary to health. Worldwide, there is concern that non-evidence-based interventions and care in labor and childbirth will remain standard practice. Therefore, access to care related to pregnancy and childbirth is considered a priority. To address safety concerns during organized births, the Safe Childbirth Checklist (SCC) was created by the World Health Organization (WHO). This checklist is a tool that combines evidence-based practices that should be provided before, during, and after childbirth. As midwives have a vital role in using this up-to-date evidence, this study was conducted to explore Iranian midwives’ perception of using SCC. MATERIALS AND METHOD: This qualitative study was conducted from January 2022 to April 2023 in two public (teaching and nonteaching) hospitals in Ahvaz, Iran. Seventeen semi-structured interviews were conducted with midwives who had more than one year of work experience in maternity wards. Participants were selected purposefully. A content analysis approach was used to analyze the data and extract themes. RESULTS: All midwives had a positive attitude toward using SCC. The midwives’ reasons for being in favor of using the checklist during the clinical procedures of childbirth are summarized in four main themes, namely “standardized maternity care practices,” “SCC as a guide for performing essential childbirth practices,” “self-efficacy of midwifery care,” and “improved maternal and neonatal outcomes.” CONCLUSION: Midwives have endorsed this checklist as a guide to standard childbirth management. It seems that the use of this checklist will help to improve the health outcomes of mothers and babies by strengthening the self-efficacy of midwives.
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