Abstract
Frequent obstetric perineal morbidity in a hospital setting with service providers inexperienced in getting evidence into practice. Clinical practice improvement methodology in a tertiary referral obstetric unit. To cease active instruction to push in the second stage of labour; encourage the adoption of the left lateral position when delivering on a bed; use of the vacuum extractor rather than forceps where instrumental delivery indicated. Improved perineal outcomes with a 21.5% increase in intact perineum rate and a 100% reduction in fourth degree perineal tears. Clinical practice improvement methodology is a useful tool for getting evidence into practice, resulting in improved clinical outcomes.
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