Detection of obstetrics early warning signs among midwives at Aga Khan University Hospital Nairobi, Kenya

Abstract

Back ground: Early identification of life threatening signs of deterioration, timely escalation or reporting of the changes, coupled with timely review and management of the patient is fundamental in improving if not maximizing patient’s safety. Various studies have revealed that physiological anomalies exist before patients are rushed to intensive care unit or even succumb. Modified early obstetrics warning signs (MEOWS) chart is developed for the obstetric population for the purpose of enabling early signs of deterioration, timely escalation and review of patient. Study objective: To determine the influence of modified early obstetrics warning signs chart in early detection of obstetric emergencies by midwives at the Aga Khan University Hospital Nairobi. Methodology: Cross-sectional study design method was used. All nurses and midwives working in labour and postnatal wards were targeted. A total of 42 respondents were recruited from whom data was collected using a structured questionnaire. Systematic random sampling was done to get 321files with MEOWS chart. Two key informants participated in the study. Data was analyzed using Statistical Package for Social Sciences (SPSS) mainly by use of descriptive statistics. Descriptive statistics included mode, mean, median, standard deviation. Data was presented by use of graphs, pie charts and tables. Findings: Results showed that majority of respondents acknowledged that MEOWS chart enables early detection of obstetrics warning signs. Most users also indicated that Color coding, alerts them of possible signs of deterioration. Most respondents also, agreed that the chart provide clear instructions on escalation and prioritization of care. However, responds by doctors, to escalations within a duration of 10min was not always adhered to. Results from the charts revealed that documentation of physiological parameters and observable variables differences was key in early trigger of warning signs and timely escalations. Conclusion: Appropriate use of MEOWS enables early detection of obstetrics warning signs, timely escalation of triggers and management of patient.