Obstetric anesthesia services in Israel snapshot (OASIS) study: a 72 hour cross-sectional observational study of workforce supply and demand

Abstract Background We planned an observational study to assess obstetric anesthesia services nationwide. We aimed to assess the effect of the anesthesia workload/workforce ratio on quality and safety outcomes of obstetric anesthesia care. Methods Observers prospectively collected data from labor units over 72 h (Wednesday, Thursday and Friday). Independent variables were workload (WL) and workforce (WF). WL was assessed by the Obstetric Anesthesia Activity Index (OAAI), which is the estimated time in a 24-h period spent on epidurals and all cesarean deliveries. Workforce (WF) was assessed by the number of anesthesiologists dedicated to the labor ward per week. Dependent variables were the time until anesthesiologist arrival for epidural (quality measure) and the occurrence of general anesthesia for urgent Cesarean section, CS, (safety measure). This census included vaginal deliveries and unscheduled (but not elective) CS. Results Data on 575 deliveries are from 12 maternity units only, primarily because a major hospital chain chose not to participate; eight other hospitals lacked institutional review board approval. The epidural response rate was 94.4%; 321 of 340 parturients who requested epidural analgesia (EA) received it. Of the 19 women who requested EA but gave birth without it, 14 (77%) were due to late arrival of the anesthesiologist. Median waiting times for anesthesiologist arrival ranged from 5 to 28 min. The OAAI varied from 4.6 to 25.1 and WF ranged from 0 to 2 per shift. Request rates for EA in hospitals serving predominantly orthodox Jewish communities and in peripheral hospitals were similar to those of the entire sample. More than a fifth (13/62; 21%) of the unscheduled CS received general anesthesia, and of these almost a quarter (3/13; 23%) were attributed to delayed anesthesiologist arrival. Conclusions Inadequate WF allocations may impair quality and safety outcomes in obstetric anesthesia services. OAAI is a better predictor of WL than delivery numbers alone, especially concerning WF shortage. To assess the quality and safety of anesthetic services to labor units nationally, observational data on workforce, workload, and clinical outcomes should be collected prospectively in all labor units in Israel.

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Correction to: Obstetric anesthesia services in Israel snapshot (OASIS) study: a 72 hour cross-sectional observational study of workforce supply and demand

Israel Journal of Health Policy Research ◽

10.1186/s13584-021-00463-z ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Gal Schtrechman-Levi ◽

Alexander Ioscovich ◽

Jacob Hart ◽

Jacob Bar ◽

Ronit Calderon-Margalit ◽

...

Keyword(s):

Observational Study ◽

Supply And Demand ◽

Obstetric Anesthesia ◽

Cross Sectional

An amendment to this paper has been published and can be accessed via the original article.

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Difficult and Failed Intubation in Obstetric Anesthesia: An Observational Study of Airway Management and Complications Associated with General Anesthesia for Cesarean Section

Obstetric Anesthesia Digest ◽

10.1097/01.aoa.0000358429.98723.0b ◽

2009 ◽

Vol 29 (3) ◽

pp. 156-157

Author(s):

N. J. McDonnell ◽

M. J. Paech ◽

O. M. Clavisi ◽

K. L. Scott

Keyword(s):

Observational Study ◽

Cesarean Section ◽

Airway Management ◽

General Anesthesia ◽

Obstetric Anesthesia ◽

Failed Intubation

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Umbilical artery lactate levels and associated maternal and newborn characteristics at Mulago National Referral Hospital: a cross-sectional observational study

BMJ Open ◽

10.1136/bmjopen-2020-043827 ◽

2021 ◽

Vol 11 (8) ◽

pp. e043827

Author(s):

Victor Ogik ◽

Mark Muyingo ◽

Moses Musooko ◽

Jolly Nankunda

Keyword(s):

Observational Study ◽

Umbilical Artery ◽

Lactate Concentration ◽

Referral Hospital ◽

Cross Sectional ◽

Mulago National Referral Hospital ◽

Vaginal Deliveries ◽

Lactate Levels ◽

National Referral Hospital ◽

Maternal And Newborn

ObjectiveTo determine the maternal and newborn characteristics associated with high umbilical artery lactate levels at Mulago National Referral Hospital.DesignCross-sectional observational study.SettingDepartment of Obstetrics and Gynecology at a national referral hospital located in the capital of Uganda, Kampala.ParticipantsWe randomly selected 720 pregnant mothers at term who presented in labour and their newborn babies.Primary outcomeUmbilical artery lactate level.ResultsDuring the study, there were 579 vaginal deliveries (18 instrumental) and 141 caesarean sections which met the inclusion criteria. One hundred and eighty-seven neonates (187) had high arterial lactate levels. The following factors were associated with an increased likelihood of high lactate concentration: male sex (adjusted OR (aOR)=1.71; 95% CI 1.16 to 2.54; p<0.05), primigravidity (aOR=2.78; 95% CI 1.89 to 4.08; p<0.001), meconium-stained liquor (aOR=5.85; 95% CI 4.08 to 8.47; p<0.001) and administration of oxytocin (aOR=1.97; 95% CI 1.00 to 3.77; p<0.05).ConclusionAbout a fifth of the babies born in Mulago National Referral Hospital during the study period had high umbilical artery lactate. The maternal-fetal factors significantly associated with high umbilical artery lactate levels included: baby’s sex, mother’s gravidity, meconium-stained amniotic fluid and oxytocin administration during labour.

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Maternal quality and safety outcomes for Asians and Pacific Islanders in Hawai‘i: an observational study from five years of statewide data

BMC Pregnancy and Childbirth ◽

10.1186/1471-2393-14-298 ◽

2014 ◽

Vol 14 (1) ◽

Cited By ~ 4

Author(s):

Tetine Sentell ◽

Ann Chang ◽

Yongjun Cheng ◽

Jill Miyamura

Keyword(s):

Observational Study ◽

Pacific Islanders ◽

Quality And Safety ◽

Safety Outcomes ◽

Maternal Quality

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The effect of nursing care delivery models on quality and safety outcomes of care: A cross‐sectional survey study of medical‐surgical nurses

Journal of Advanced Nursing ◽

10.1111/jan.13997 ◽

2019 ◽

Vol 75 (10) ◽

pp. 2144-2155 ◽

Cited By ~ 4

Author(s):

Farinaz Havaei ◽

Maura MacPhee ◽

V. Susan Dahinten

Keyword(s):

Nursing Care ◽

Care Delivery ◽

Survey Study ◽

Quality And Safety ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Outcomes Of Care ◽

Surgical Nurses ◽

Safety Outcomes ◽

Delivery Models

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Profil Penyakit Malaria Di Rumah Sakit Islam Siti Rahmah Padang Tahun 2018

Health & Medical Journal ◽

10.33854/heme.v2i2.546 ◽

2020 ◽

Vol 2 (2) ◽

pp. 08-15

Author(s):

Rahma Triyana ◽

Salmi Salmi

Keyword(s):

Observational Study ◽

Frequency Distribution ◽

Cross Section ◽

Laboratory Tests ◽

Age Group ◽

Normal Range ◽

Cross Sectional ◽

West Sumatra ◽

Severity Of The Disease

Malaria is one of the health problems in Indonesia, especially West Sumatra. Determination of the description of Malaria disease in an area is needed to determine the spread and severity of the disease. This study aims to determine the frequency distribution according to age, sex and place of residence, description of the types of Plasmodium causes of Malaria and hematological features in Malaria patients at Siti Rahmah Padang Hospital in 2018. This type of research is a descriptive observational study with an approach or design cross section (cross sectional). The frequency distribution of Malaria sufferers in Siti Rahmah Padang Hospital in 2018 according to the highest age was in the age group 21-30 years as many as 28 cases (36.8%), the highest sex among men was 46 (60.5%) and the highest number of residences was found in Koto Tangah sub-district there were 31 cases (40.8%). The type of Plasmodium found in Malaria cases in Siti Rahmah Padang Hospital in 2018 was P. vivax (73 cases (96.05%)) and P. falciparum (3 cases (3.95%)). The results of laboratory tests on Hb, hematocrit, platelet and leukocyte levels in Malaria positive patients in Siti Rahmah Padang Hospital in 2018 were in the normal range.

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