Evidence map›Paper›PMID 39331149›Full record

ArticleInternational urogynecology journal2024

Obstetric Anal Sphincter Injury Care Bundle: A Quality Improvement Initiative.

T Clark Powell, Tanya P Hoke, Kyle P Norris, Margaret R Page, Allison Todd, David T Redden, Cynthia G Brumfield, J Michael Straughn, Holly E Richter

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International urogynecology journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

T Clark PowellDivision of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, 1700 6Th Ave S, 176F Suite 10382, Birmingham, AL, 35233, USA. thomaspowell@uabmc.edu.
Tanya P HokeDivision of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, 1700 6Th Ave S, 176F Suite 10382, Birmingham, AL, 35233, USA.
Kyle P NorrisDivision of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, 1700 6Th Ave S, 176F Suite 10382, Birmingham, AL, 35233, USA.
Margaret R PageDivision of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA.
Allison ToddDepartment of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA.
David T ReddenCenter for Clinical and Translational Science, University of Alabama at Birmingham, Birmingham, AL, USA.
Cynthia G BrumfieldDivision of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA.
J Michael StraughnDivision of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA.
Holly E RichterDivision of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, 1700 6Th Ave S, 176F Suite 10382, Birmingham, AL, 35233, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introduction and hypothesisThe objective was to implement an evidence-based peri-partum care bundle for women sustaining obstetric anal sphincter injuries and to evaluate compliance with recommendations for antibiotics use, repair in the operating room, and follow-up before and after implementation.

methodsThis project was reviewed by the Institutional Review Board and determined to be exempt. A clinical care bundle containing education and standardized orders in the electronic medical record was implemented. Characteristics of pre- (October 2017 to September 2019) and post-intervention (October 2019 to August 2021) cohorts were compared and compliance with recommendations for antibiotics use, surgical repair location, and follow-up were evaluated. Chi-squared, Fisher's exact, ANOVA F, and Kruskal-Wallis tests were performed, as indicated. Significance level was p < 0.05.

resultsA total of 185 cases were identified. Seventy-five percent of women were nulliparous. Mean gestational age was 39 weeks. Pre- and post-intervention groups did not differ in age, BMI, race, parity, gestational age, comorbidities, birthweight, or delivery type. Ninety-eight cases were identified pre-implementation. Eighty-six (88%) had third-degree lacerations. Post-implementation, 87 cases were identified. Seventy (80%) had third-degree lacerations (p = 0.17). Recommended antibiotic-type use improved from 35% pre-implementation to 93% post-implementation (p < 0.001). Repair in the operating room was similar pre-implementation and post-implementation (16.0% vs 12.6%, p = 0.48). Post-partum follow-up within 2 weeks improved from 16.3% pre-implementation to 52.8% post-implementation and mean time to follow-up was shorter post-implementation than pre-implementation (18 vs 33 days; both p < 0.001).

conclusionsImplementation of an evidence-based peri-partum care bundle resulted in standardization of care in accordance with established recommendations. Compliance with recommendations for surgical repair in the operating room remained unchanged.

Indexed as

Anal CanalLacerationsPatient Care BundlesQuality ImprovementAdultAnti-Bacterial AgentsDelivery, ObstetricFemaleGuideline AdherenceHumansObstetric Labor ComplicationsPregnancyRetrospective StudiesAnti-Bacterial AgentsClinical care bundleObstetric anal sphincter injuryQuality improvement

Identifiers

PMID39331149
PMCPMC11638415

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.