Title | Relationship of Hospital Staff Coverage and Delivery Room Resuscitation Practices to Birth Asphyxia. |
Publication Type | Journal Article |
Year of Publication | 2017 |
Authors | Tu JH, Profit J, Melsop K, Brown T, Davis A, Main E, Lee HC |
Journal | Am J Perinatol |
Volume | 34 |
Issue | 3 |
Pagination | 259-263 |
Date Published | 2017 Feb |
ISSN | 1098-8785 |
Keywords | Anesthesiology, Asphyxia Neonatorum, California, Checklist, Delivery Rooms, Hospitals, High-Volume, Hospitals, Maternity, Hospitals, Rural, Hospitals, Urban, Humans, Infant, Newborn, Medical Staff, Hospital, Neonatology, Obstetrics, Pediatrics, Resuscitation, Specialization, Surveys and Questionnaires, Workforce |
Abstract | The objective of this study was to assess utilization of specialist coverage and checklists in perinatal settings and to examine utilization by birth asphyxia rates. This is a survey study of California maternity hospitals concerning checklist use to prepare for delivery room resuscitation and 24-hour in-house specialist coverage (pediatrician/neonatologist, obstetrician, and obstetric anesthesiologist) and results linked to hospital birth asphyxia rates (preterm and low weight births were excluded). Of 253 maternity hospitals, 138 responded (55%); 59 (43%) indicated checklist use, and in-house specialist coverage ranged from 38% (pediatrician/neonatologist) to 54% (anesthesiology). In-house coverage was more common in urban versus rural hospitals for all specialties ( < 0.0001), but checklist use was not significantly different ( = 0.88). Higher birth volume hospitals had more specialist coverage ( < 0.0001), whereas checklist use did not differ ( = 0.3). In-house obstetric coverage was associated with lower asphyxia rates (odds ratio: 0.34; 95% confidence interval [CI]: 0.20, 0.58) in a regression model accounting for other providers. Checklist use was not associated with birth asphyxia (odds ratio: 1.12; 95% CI: 0.75, 1.68). Higher birth volume and urban hospitals demonstrated greater in-house specialist coverage, but checklist use was similar across all hospitals. Current data suggest that in-house obstetric coverage has greater impact on asphyxia than other specialist coverage or checklist use. |
DOI | 10.1055/s-0036-1586505 |
Alternate Journal | Am J Perinatol |
PubMed ID | 27487231 |