Clarification of Safe Delivery by Iranian Experts Based on Clinical Governance: A Qualitative Study
AbstractObjective:To clarify the principles of a safe delivery based on Clinical Governance Criteria, as recommended by the pertinent experts.Materials and methods:The current study was part of a qualitative research conducted by content analysis method in 2013 and purposive sampling, performing 24 in-depth interviews based on semi-structured questions and analyzed using thematic content analysis. The participants in this research included midwives, obstetricians, managers, and hospital doctors. The data were under continuous consideration and comparative analysis in order to achieve data saturation.Results:The main concepts derived from interpretations of the pertinent experts include: Patient & Public involvement; Risk Management; Education; Clinical efficiency; Clinical audit; Personnel & Management.Conclusion:In a safe delivery, there is a vicious cycle of causes the elimination of which is only possible through benchmarking patterns that attend to most aspects of a safe delivery.Changes to services require utilization of appropriate change management strategies.
Sachs JD, McArthur JW. The millennium project: a plan for meeting the millennium development goals.The Lancet 2005;365:347-53.
Organization WHO. Country Cooperation Strategy for WHO and Islamic Republic of Iran 2010– 4.
The Royal College of Midwives, The Royal College of Anaesthetists, The Royal College of Paediatrics and Child Health. Safer Childbirth: Minimum standards for the organisation and delivery of care in labour, 2007.
AbouZahr C.Safe Motherhood: a brief history of the global movement 1947–2002. British Medical Bulletin 2003; 67: 13–25.
Quick J, Gteenlick M, Roghmann K.Prenatal Care and Pregnancy Outcome in an HMO General Population: A Multivariate Cohort Analysis. AJPH 1981; 71:381-90.
Simkhada B, Teijlingen ER, Porter M, Simkhada P. Factors affecting the utilization of antenatal care in developing countries: systematic review of the literature. JAdv Nurs 2008;61:244-60.
Lotfi R, et al. Quality of prenatal care in LQAS method in Astara health centers method. Guilan University of Medical Sciences Journal 2004; 58 : 33-40. [In Persian]
Moradi-Lakeh M, Ramezani M, Naghavi M. Equality in safe delivery and its determinants in Iran. Archives of Iranian medicine 2007;10:446-51.
Donnay F. Maternal survival in developing countries: what has been done, what can be achieved in thenext decade. International Journal of Gynecology & Obstetrics 2000;70:89-97.
Scally G, Donaldson LJ. The NHS's 50 anniversary.Clinical governance and the drive for quality improvement in the new NHS in England.Bmj 998;317:61-5.
Malcolm L, Mays N. New Zealand's independent ractitioner associations: a working model of clinical governance in primary care? Bmj 1999;319:1340-2.
Wright L, Barnett P, Hendry Ch. Clinical leadership and clinical governance, report commissioned by the clinical Association of New Zealand for the ministry of health, 2001.
Ravaghi H, Mohseni M, Rafiei S, Zadeh NS, Mostofian F, Heidarpoor P. Clinical Governance in Iran: Theory to Practice. Procedia - Social and Behavioral Sciences 2014;109:1174-9.
Hooshmand E, Tourani S, Ravaghi H, Ebrahimipour H. Challenges in evaluating clinical governance systems in iran: a qualitative study. Iranian Red Crescent medical journal 2014;16:e13421.
Arulkumaran S. Clinical governance and standards in UK maternity care to improve quality and safety.Midwifery 010; 26: 485–7.
Streubert HJ, Carpenter DR. Qualitative research in nursing، advancing the humanistic imperative. 3rd ed. Philadelphia: Lippincott. 2003.
World Health Organization. Human resource development for maternal health and safe motherhood : report of a task force meeting. Geneva,1990.
Abbaspoor Z, Moghaddam -Banaem L, Ahmadi F, Kazemnejad A.Iranian mothers' selection of a birth method in the context of perceived norms: A content analysis study. Midwifery 2014; 30: 804–9.
Arora NK, McHorney CA. Patient preferences for medical decision making: who really wants to participate? Medical care 2000;38:335-41.
Woogara J. Patients’ rights to privacy and dignity in the NHS. Nurs Stand 2005;19:33-7.
Woogara J. Human rights and patients’ privacy in UK hospitals. Nursing Ethics 2001;8:234-46.
Backett EM, Davies AM, Petros-Barvazian A. The risk approach in health care: with special reference to maternal and child health, including family planning 1984;76:1-113.
Kenyon C. Risk management standards in midwifery are no substitute for personal knowledge and accountability. complement TherClinPract 2009;15:209-11.
Winn SH. Assessing and credentialing standards of care: the UK Clinical Negligence Scheme for Trusts (CNST, Maternity). Best Practice & Research Clinical Obstetrics &Gynaecology 2007;21:537-55.
Graham WJ. Criterion-based clinical audit in obstetrics: bridging the quality gap? Best Pract Res ClinObstetGynaecol 2009;23:375-88.
Bullough C, Graham W. Clinical audit learning from systematic case reviews against explicit criteria 2004:125–37.