CA Carter

D Pittet

Dileep Mavalankar

DM Yealy

Harin A. Karunajeewa

J Hussein

Jacqueline Bell

Julia Hussein

K. V. Ramani

Kalpesh Patel

KS Khan

Leighton Walker

Lovney Kanguru

M Ashraf

MC Ruhe

N Tharpe

P Rajaram

PN Anandalakshmy

Purvi Patel

R Kumar

R Mehta

Rajesh Mehta

RW Haley

S Singh

SP Stone

TG Rana

PLoS ONE

English

PubMed

Crossref

The Effect of Surveillance and Appreciative Inquiry on Puerperal Infections: A Longitudinal Cohort Study in India

OBJECTIVE: To evaluate the effects of an intervention comprising surveillance and an organisational change called Appreciative Inquiry on puerperal infections in hospitals in Gujarat state, India. METHODS: This longitudinal cohort study with a control group was conducted over 16 months between 2010 and 2012. Women who delivered in six hospitals were followed-up. After a five month pre-intervention period, the intervention was introduced in three hospitals. Monthly incidence of puerperal infection was recorded throughout the study in all six hospitals. A chi-square test and logistic regression were used to examine for associations, trends and interactions between the intervention and control groups. FINDINGS: Of the 8,124 women followed up, puerperal infections were reported in 319 women (3.9%) over the course of the study. Puerperal sepsis/genital tract infections and urinary tract infections were the two most common puerperal infections. At the end of the study, infection incidence in the control group halved from 7.4% to 3.5%. Levels in the intervention group reduced proportionately even more, from 4.3% to 1.7%. A chi-square test for trend confirmed the reduction of infection in the intervention and control groups (p<0.0001) but the trends were not statistically different from one another. There was an overall reduction of infection by month (OR = 0.94 95% CI 0.91-0.97). Risk factors like delivery type, complications or delivery attendant showed no association with infection. CONCLUSION: Interruption of resource flows in the health system occurred during the intervention phase, which may have affected the findings. The incidence of infection fell in both control and intervention groups during the course of the study. It is not clear if appreciative inquiry contributed to the reductions observed. A number of practical and methodological limitations were faced. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN03513186

K V Ramani

Directory of Open Access Journals

The effect of surveillance and appreciative inquiry on puerperal infections: a longitudinal cohort study in India.

<div>ObjectiveTo evaluate the effects of an intervention comprising surveillance and an organisational change called Appreciative Inquiry on puerperal infections in hospitals in Gujarat state, India.MethodsThis longitudinal cohort study with a control group was conducted over 16 months between 2010 and 2012. Women who delivered in six hospitals were followed-up. After a five month pre-intervention period, the intervention was introduced in three hospitals. Monthly incidence of puerperal infection was recorded throughout the study in all six hospitals. A chi-square test and logistic regression were used to examine for associations, trends and interactions between the intervention and control groups.FindingsOf the 8,124 women followed up, puerperal infections were reported in 319 women (3.9%) over the course of the study. Puerperal sepsis/genital tract infections and urinary tract infections were the two most common puerperal infections. At the end of the study, infection incidence in the control group halved from 7.4% to 3.5%. Levels in the intervention group reduced proportionately even more, from 4.3% to 1.7%. A chi-square test for trend confirmed the reduction of infection in the intervention and control groups (p<0.0001) but the trends were not statistically different from one another. There was an overall reduction of infection by month (OR = 0.94 95% CI 0.91–0.97). Risk factors like delivery type, complications or delivery attendant showed no association with infection.ConclusionInterruption of resource flows in the health system occurred during the intervention phase, which may have affected the findings. The incidence of infection fell in both control and intervention groups during the course of the study. It is not clear if appreciative inquiry contributed to the reductions observed. A number of practical and methodological limitations were faced.Trial RegistrationControlled-Trials.com <a href="http://www.controlled-trials.com/ISRCTN03513186" target="_blank">ISRCTN03513186</a></div

Julia Hussein (152087)

K. V. Ramani (517469)

Lovney Kanguru (152095)

Kalpesh Patel (517470)

Jacqueline Bell (350803)

Purvi Patel (517471)

Leighton Walker (517472)

Rajesh Mehta (517473)

Dileep Mavalankar (517474)

The Francis Crick Institute

Hussein, Julia

Ramani, KV

Kanguru, Lovney

Patel, Kalpesh

Bell, Jacqueline Sarah

Patel, Purvi

Walker, Leighton

Mehta, Rajesh

Mavalankar, Dileep

Aberdeen University Research

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The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals.

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World Health Organization The prevention and management of puerperal sepsis. Report of technical working group. WHO/FHE/MSM/95.4

World Health Organization.

The effect of surveillance and appreciative inquiry on puerperal infections : a longitudinal cohort study in India

To evaluate the effects of an intervention comprising surveillance and an organisational change called Appreciative Inquiry on puerperal infections in hospitals in Gujarat state, India.This longitudinal cohort study with a control group was conducted over 16 months between 2010 and 2012. Women who delivered in six hospitals were followed-up. After a five month pre-intervention period, the intervention was introduced in three hospitals. Monthly incidence of puerperal infection was recorded throughout the study in all six hospitals. A chi-square test and logistic regression were used to examine for associations, trends and interactions between the intervention and control groups.Of the 8,124 women followed up, puerperal infections were reported in 319 women (3.9%) over the course of the study. Puerperal sepsis/genital tract infections and urinary tract infections were the two most common puerperal infections. At the end of the study, infection incidence in the control group halved from 7.4% to 3.5%. Levels in the intervention group reduced proportionately even more, from 4.3% to 1.7%. A chi-square test for trend confirmed the reduction of infection in the intervention and control groups (p<0.0001) but the trends were not statistically different from one another. There was an overall reduction of infection by month (OR = 0.94 95% CI 0.91–0.97). Risk factors like delivery type, complications or delivery attendant showed no association with infection.Interruption of resource flows in the health system occurred during the intervention phase, which may have affected the findings. The incidence of infection fell in both control and intervention groups during the course of the study. It is not clear if appreciative inquiry contributed to the reductions observed. A number of practical and methodological limitations were faced

Hussein Julia

Ramani K. V.

Kanguru Lovney

Patel Kalpesh

Bell Jacqueline

Patel Purvi

Walker Leighton

Mehta Rajesh

Mavalankar Dileep

Public Library of Science (PLOS)

https://figshare.com/articles/_The_Effect_of_Surveillance_and_Appreciative_Inquiry_on_Puerperal_Infections_A_Longitudinal_Cohort_Study_in_India_/919926

The effect of surveillance and appreciative inquiry on puerperal infections : a longitudinal cohort study in India

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Directory of Open Access Journals

The Francis Crick Institute

Aberdeen University Research

Public Library of Science (PLOS)

Public Library of Science (PLOS)