Development of quality of care indicators from systematic reviews: the case of hospital delivery

Bonfill, Xavier; Roqué, Marta; Aller, Marta Beatriz; Osorio, Dimelza; Foradada, Carles; Vives, Àngels; Rigau, David

doi:10.1186/1748-5908-8-42

Table 3 Quality of care indicators generated in the project

From: Development of quality of care indicators from systematic reviews: the case of hospital delivery

	Indicator	Target population	ICD-9 codes^a	Indicator formula^b	Standard^c
1	Proportion of women with singleton pregnancies and threatened preterm labour (TPL) who receive corticosteroids²⁵	Women with TPL and preterm labour	644.03, 644.10, 644.13, 644.20, 644.21	D: Singleton pregnancies between 26-34w	≈100
				N: Women who received corticoids
				E: Corticoids contraindications
2	Proportion of women who are treated with calcium channel blockers (CCB) for inhibiting preterm labour²⁶	Women with TPL and preterm labour	644.03, 644.10, 644.13, 644.20, 644.21	D: Pregnancies between 22-34w	≈100
				N: Women who received CCB
				E: Contraindication to CCB
3	Proportion of women with threatened preterm labour treated with magnesium sulphate²⁷	Women with TPL and preterm labour	644.03, 644.10, 644.13, 644.20, 644.21	D: Women who received pharmacological treatment for TPL	≈0
				N: Women who received magnesium sulphate
				E: None
4	Proportion of women with preterm rupture of membranes (PRM) who receive antibiotic treatment²⁸	Women with PRM	658.10, 658.11	D: Pregnancies between 22-34w with PRM	≈100
				N: Women who received antibiotics
				E: None
5	Proportion of women with post-term pregnancy who give birth after 41 weeks of gestation²⁹	Women with >=41w pregnancy	641.X1, 642.X1, 676.X1	D: Women with > =41w pregnancy	≈0
				N: Women with labour induction
				E: Spontaneous labour, non-urgent caesarean delivery
6	Proportion of women with severe pre-eclampsia who were treated with magnesium sulphate³⁰	Women with severe preeclampsia	642.5	D: Women with severe pre-eclampsia	≈100
				N: Women who received magnesium sulphate
				E: Contraindication to magnesium sulphate
7	Proportion of women with eclampsia treated with magnesium sulphate^22,23,24	Women with eclampsia	642.6	D: Women with eclampsia	≈100
				N: Women who received magnesium sulphate
				E: Contraindication to magnesium sulphate
8	Proportion of women with term pregnancies and a breech presentation in which external cephalic version is performed or offered³¹	Women with breech presentation	73.91	D: Breech presentation	≈100
				N: Women in whom cephalic version was performed or offered
				E: None
9	Proportion of unjustified episiotomies³⁴	Women in whom episiotomy was performed	73.6	D: Women in who episiotomy was performed	≈0
				N: Procedures without any reason documented
				E: None
10	Proportion of women whose second-degree perineal tear or episiotomy is repaired with continuous suture³⁵	Women with second-degree perineal tear or episiotomy	664.10, 664.11, 644.14, 73.6	D: Women with second-degree perineal tear or episiotomy	≈100
				N: Women in whom continuous suture was performed
				E: None
11	Proportion of women who are given an enema during labour³⁶	Women in labour	641.X1, 642.X1, 676.X1	D: Women in labour	≈0
				N: Women who were given an enema
				E: None
12	Proportion of women having perineal shaving on admission to the delivery room³⁷	Women in labour	641.X1, 642.X1, 676.X1	D: Women in labour	≈0
				N: Women for whom perineal shaving was performed
				E: None
13	Proportion of women who are administered uterotonics in the third stage of labour³⁸	Women in labour	641.X1, 642.X1, 676.X1	D: Women in labour	≈100
				N: Women who received uterotonics
				E: Contraindication to uterotonics, patient refusal to receive uterotonics
14	Proportion of women undergoing caesarean section who receive antibiotic therapy³⁹	Women on whom caesarean was performed	74.XX	D: Women who received caesarean	≈100
				N: Women who received antibiotics
				E: None
15	Proportion of women whose peritoneum is sutured at caesarean delivery⁴⁰	Women on whom caesarean was performed	74.XX	D: Women who received caesarean	≈0
				N: Women for who peritoneum was sutured
				E: None
16	Proportion of health professionals who use double gloves when attending a woman with a blood-borne disease⁴³	Health professionals performing surgical procedures	None	D: Health professionals who performed surgical procedures in woman with a blood-borne disease	≈100
				N: Health professionals who used double gloves
				E: None
17	Proportion of Rh-negative women who are given Anti-D within 72 hours after the birth of an Rh-positive or Rh-undetermined baby⁴¹	Rh-negative pregnant women	None	D: Rh-negative women with Rh-positive newborn	≈100
				N: Women who received Anti-D
				E: Women with prior Rh sensitization.
18	Proportion of women with incomplete miscarriage who, if a surgical evacuation of retained products is carried out, undergo a vacuum aspiration⁴²	Women with incomplete miscarriage	634.X1 -638.X1	D: Women with incomplete miscarriage	≈100
				N: Women in who vacuum aspiration was performed
				E: Contraindication to vacuum aspiration

^a In this column, the value “X” means any number between 0 to 9.
^b In this column, (D) Denominator, (N) Numerator (E) Exclusion criteria.
^c Theoretical standards: 100% means a desirable event (higher values indicate appropriate performance) and 0% an undesirable event (lower values indicate inappropriate performance).

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