QI Story: Enhancing Labor Monitoring Through Comprehensive Partograph Documentation

To Achieve Complete Documentation of Partographs

Presented By: Chancy Banda, Billy Mzikuola and Gloria Kalonga

Frontline healthcare professionals at Malawi’s Ndamera Health Centre’s labour ward attempted to address the problem of incomplete partograph paperwork, which has been there since January 2022, to improve the standard of care during labour and delivery. It was found that just 20% of the time partograph parameters get properly documented, which raised concerns about supportive supervision and data checks. The facility established a clear objective to address this problem: between July 1, 2022, and December 31, 2022, to raise the percentage of complete partograph documentation from 20% to 85%.

“During our QI activities and supervision we noted some gaps in the documentation of partographs among women delivering at Ndamera Health Centre,” said Chancy. Chancy a senior Nursing and Midwifery Officer and the District QI Focal Person added that the team therefore had to sit down and plan a QI project to improve the quality of care offered at the maternity section.

Billy Mzikuola, also serving as a District QI Focal Person, added, “The team came up with three change ideas namely monthly Continuing Professional Development program, daily review of partographs and peer-to-peer mentorship”. 

Watch the video submission below:

The research aimed to determine the extent to which healthcare workers were using partographs as a monitoring tool during labour by examining the documentation of these vital parameters. The partograph is a valuable tool for monitoring labour and delivery, with evidence suggesting that its appropriate use can reduce complications during childbirth.

Check out the Standards for Maternal and Neonatal Care.

The results of this quality improvement project have significant implications for improving the quality of care provided to women during labour and delivery. The project recommended that health facilities implement peer-to-peer mentorship programs and partograph reviews using checklists to ensure complete documentation. This approach aims to address the issue and enhance pregnancy outcomes by facilitating better monitoring and documentation of labour progress. The Continuing Professional Development (CPD) program on partograph use for healthcare workers was found to be effective, motivating staff to complete partograph documentation. Furthermore, combining supportive supervision with regular partograph reviews and audits proved to improve partograph documentation, highlighting the importance of sustaining this practice at the facility.

The project’s conclusion emphasizes the critical role that comprehensive documentation plays in caring for women in labour and delivery. Poor documentation of essential parameters indicates insufficient monitoring of labour progress, which can result in adverse pregnancy outcomes. The project demonstrated that understanding the issues and providing tailored solutions can lead to improvements in pregnancy outcomes. It also highlighted the effectiveness of Continuing Professional Development, supportive supervision, and regular reviews in achieving comprehensive partograph documentation.

Read More about the QI story below:

This is part of the storytelling contest submission for World Patient Safety Month. Read more here.

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