Quality improvement project to increase compliance of administration of corticosteroids and aminophylline in neonatal department of Mibilizi District Hospital

Abstract

Purpose The purpose of this study is to describe how the hospital influenced the practice of corticosteroids and aminophylline administration by applying strategic problem solving. Under five child mortality is a challenge in Rwanda. Although it has been shown that administering corticosteroids and aminophylline can reduce the mortality of premature neonates, the use of these medications were low at Mibilizi District Hospital in Rwanda. Design/methodology/approach This project used a pre- and post-intervention study design, utilizing patient file audit to evaluate the impact of our intervention on the compliance of corticosteroids administration to pregnant mothers in premature labour and aminophylline to premature neonates, using the Strategic Problem Solving approach. Findings The intervention significantly increased the rate of giving corticosteroids to mothers at risk of premature delivery from 26 per cent to 60 per cent p-value = 0.009. The provision of aminophylline to premature neonates under 34 weeks of gestation significantly increased from 65 per cent to 100 per cent p-value = 0.002. Practical implications This study illustrates how a multidisciplinary team was able to use the eight steps of strategic problem solving to increase the administration rates of corticosteroids and aminophylline. The hospital should continue to support quality improvement efforts using strategic problem solving approach to prevent premature neonatal deaths and improve quality of care. Originality/value Findings from this study may be useful for hospitals in resource-challenged settings seeking to improve the administration of corticosteroids and aminophylline to prevent premature neonatal deaths.