Reducing the emergency cesarean section waiting time on decision to incision at maternity ward of Kinihira provincial hospital

Abstract

Background: Achieving 30 minutes guideline of the American College of obstetricians and Gynecologists and the Royal College of Obstetricians and Gynecologists (RCOG) is still a challenge in low limited resource settings in developing countries. In maternity ward at Kinihira provincial hospital; baseline data showed that from January to December 2019; only 10.1% (46/454) of emergency cesarean sections were executed in 30 minutes. Objective of the study: The objective of the study was to reduce the emergency caesarean section waiting time on decision to incision from 89.9 % to 60 % by May 2021. Methodology: This study used pre and post interventional study design to reduce the emergency caesarean section waiting time on decision to incision by using strategic problem-solving steps Results: The waiting time of emergency cesarean sections was reduced from 89.9% to 68.7% (P=0.03) after the intervention, the total median time on decision to incision was also dropped from 60 2.to 37.2 minutes (p=0.01). Similarly, none reassuring fetal heart rate cesarean indications performed within 30 minutes was also significantly increased from 6.1% to 16.9% (p =0.01) Conclusion: Given to the complexity of emergency cesarean section; a well-trained obstetric team is required, teamwork skills and availing clinical guideline for emergency supplies and surgical materials organization are also essential to reduce long waiting time on decision to incision time.