Objective:

To assess the effect of a cycle of quality improvement on the implementation of evidence-based practices in the treatment of women with gestational hypertensive diseases admitted to the Maternal Intensive Care Unit (MICU).

Method:

Quasi-experimental study, without a control group, performed in a MICU of a university hospital which followed the steps of a cycle of quality improvement. Nine process criteria were assessed in all women admitted with a diagnosis of gestational hypertensive diseases in the periods before (n = 50) and after the intervention (n = 50) in 2015. The compliance was estimated with the confidence interval of 95 %, the non-conformities with Pareto charts and the significance of improvement with one-tailed Z-test (α = 5 %).

Results:

The initial quality level was high in six out of nine criteria (amplitude: 94-100 %), the practices with the lowest adherence were "magnesium sulfate maintenance" (54 %), "fetal ultrasound request" (72 %) and "intravenous fluid restriction" (78 %). There was absolute improvement in five out of nine criteria (amplitude: 2-16 %), which was significant for fetal ultrasound request (absolute improvement: 16 %; p = 0.023) and for the total criteria (4%; p = 0.01).

Conclusion:

The proposed intervention of quality improvement increased the adherence to evidence-based recommendations for the treatment of patients with gestation-al hypertension admitted to a MICU.

        · abstract in Portuguese | Spanish     · text in Portuguese     · Portuguese ( pdf )