Development of Guidelines for the Care of Newborns with Complications in the Obstetrics Department at Raman Hospital

Abstract

Background: The Obstetrics Department at Raman Hospital is responsible for caring for 700–800 newborns delivered vaginally each year. In addition, the department provides care for approximately 400–500 newborns annually who are less than 48 hours old and referred from regional hospitals. Given the high volume of newborn care required, the department has encountered several adverse events under the traditional care approach. These include a delay in performing an umbilical venous catheter (UVC) procedure in one case, and delays in medical assessment and treatment in four cases. In response to these issues, the obstetrics team held clinical meetings to review and improve their work processes. The goal was to enhance efficiency, minimize critical errors that could pose serious risks to newborns' lives, and reduce the potential for legal action.

Objectives: 1. To revise and establish protocols for the management of newborns in the Obstetrics Department.  2. To mitigate risks associated with adverse events for newborns in the Obstetrics Department.

Methodology: The team engaged in collaborative meetings with pediatricians and relevant departments to analyze the causes of existing problems and develop guidelines for receiving newborns in the delivery room. Staff were informed of these protocols, and performance was evaluated.

Results: Since the implementation of these guidelines from 2021 to the present, compliance rates for newborn management in the delivery room have been reported at 50%, 80%, 90%, and 100%, respectively. Reports of adverse events for newborns in the delivery room were 2  2 and 1 cases, with no adverse events recorded in 2024.

Conclusion: The development of these guidelines has led to staff adherence to protocols, achieving the set targets, which demonstrates the establishment of an effective operational system.