Indicateurs Sécurité En Obstétrique : Une Étude Delphi

Objective. - Clinical indicators are increasingly used to assess safety of patient care. In obstetrics, only a few indicators have been validated to date and none is used across specialties. The purpose of this study was to identify and assess for face and content validity a group of safety indicators that could be used by anaesthetists, obstetricians and neonatologists involved in labour and delivery units.Materials and methods. - We first conducted a systematic review of the literature to identify potential measures. Indicators were then validated by a panel of 30 experts representing all specialties working in labour and delivery units. We used the Delphi method, an iterative questionnaire-based consensus seeking technique. Experts determined on a 7-point Likert scale (1 = most representative/7 = less representative) the soundness of each indicator as a measure of safety and their possible association with errors and complications caused by medical management.Results. - We identified 44 potential clinical indicators from the literature. Following the Delphi process, 13 indicators were considered as highly representative of safety during obstetrical care (mean score <= 2.3). Experts ranked 6 of these indicators as being strongly associated to potential errors and complications.Conclusions. - We identified and validated for face and content, a group of six clinical indicators to measure potentially preventable iatrogenic complications in labour and delivery units. (C) 2010 Elsevier Masson SAS. All rights reserved.