Improving Partograph Documentation and Use by Health Workers of Bwera Hospital

Abstract

In this action based research we undertook a pragmatic quality-improvement approach to the research. This article describes improvements realized when an action research was carried out on maternity department in Bwera Government hospital Kasese district. We describe how practice research engagement was employed in the maternity department to contribute to health service improvement. The action research was carried between the months of June to August 2014, the study aimed at improving partograph documentation and use by midwives and doctors working in the department. The study used an exploratory, descriptive process improvement research to determine the most pressing problem on the department that required urgent improvement. Problems identified included inadequate infection prevention, poor partograph use and documentation, Comprehensive Emergency Obstetric and Neonatal Care (CEmONC), and failure to adhere to the 5S principles. Through pairwise ranking, inadequate partograph documentation and use by midwives and doctors while assisting mothers to deliver was the prioritized problem that required urgent improvement. Basing on guidelines adopted from the Ministry of Health by Engender Health Project on correct use and documentation of partograph, the number of deliveries conducted and had all the 18 (100%) indicators of the partograph monitored and documented stood at 8.3%. This, therefore, led to training all midwives and doctors working on maternity ward on correct use and documentation of a partograph, increase attachment of partographs to clients’ files and address the practice of leaving partographs blank. The research targeted to increase the percentage of mothers monitored in labour by the correct documentation and use of the partograph. Monitoring of mothers through correct documentation and use of the Partograph at maternity department improved to 89.3%. Marked changes were realized in attaching partographs on clients’ files from 96% to 99% and reduction of partographs left blank from 8% to 3%. It is therefore recommended that clinical leadership, continuous professional development and support supervision on partograph use and documentation be emphasized in