Improving Prophylactic Antibiotic Compliance After Assisted Vaginal Birth

Dr. Khalid Alloush, Dr. Anqa Khan, Dr. Joy Mawby, Dr. Tabitha Oosterhouse
Ysbyty Gwynedd, Betsi Cadwaladr University Health Board (BCUHB)

 

Audit

The audit showed there was room for improvement in prescribing antibiotic prophylaxis to patients
having assisted vaginal birth, especially in room births (91% in theatre births and 53% in room births)

 

Action Plan

Our aim was to improve compliance by at least 20%

➢Modifying the AVB proforma to include antibiotics prescription
➢Circulating information regarding RCOG guidance and the ongoing project

➢Creating a new modified WHO checklist for in-room AVB (addressed several key areas from risk meetings including antibiotics)
➢Putting posters up on labour ward and on the AVB trolley to minimise the risk of missing the antibiotics

Reaudit

➢The reaudit showed improvement in adherence to the guidance on antibiotic prophylaxis with AVB (100% in theatre births and 86% in room births).
➢The AVB checklist was approved locally and will be added to the trust guidelines.

➢There was also improvement in adherence to using co-amoxiclav, increasing from 41% to 86% for people without penicillin allergy.

 

Conclusions

➢This project improved the local compliance to the RCOG guidance on prophylactic antibiotics with AVB.
➢ Further monitoring and audits are planned to maintain this improvement.

 

References

Murphy DJ, Strachan BK, Bahl R, on behalf of the Royal College of Obstetricians Gynaecologists. Assisted Vaginal Birth. BJOG 2020; 127: e70–e112.