Audit of a fetal central monitoring station in a clinical setting

Abstract

Objective. To conduct an audit of the Omniview-SisPorto® central monitoring station (CMS) and determine the effect of the measures undertaken to correct identified problems.

Methods. All cardiotocograms (CTGs) recorded in randomly selected days of 2006 and 2009, both in the outpatient clinic and labor ward, were reviewed to assess the following parameters: tracing identification, duration, signal quality, signal loss, acquisition method, and time elapsed between tracing-end and birth. A random sample of cases was compared with original paper recordings and 25% of CTGs were re-retrieved for comparison with first retrieval.

Results. Antepartum tracings were identified in 92% of cases. Mean signal quality rose from 96.4% in 2006 to 97.1% in 2009 (p = 0.009). Mean signal loss fell from 7.4% to 5.8% (p = 0.012). Intrapartum CTGs were identified in 44% of cases in 2006 and in 69% in 2009 (p < 0.001). Mean interval between tracing-end and birth decreased from 12.0 to 8.4 min (p < 0.001). Coincidence of variables in tracings retrieved twice increased between 2006 and 2009. All retrieved tracings matched the original paper recordings. Several technical problems identified in 2006 were not found in 2009.

Conclusions. The Omniview-SisPorto® system showed reliable recording, storage, and retrieval of CTGs. Auditing of fetal CMSs allows improvement of their performance and use.

Keywords:

• Cardiotocography
• heart rate
• fetal
• fetal monitoring
• computer analysis
• clinical audit

Acknowledgments

The authors would like to thank the ERIC Institute, UK, for providing the Health Devices reference. The study was supported by a research grant from ADI 70/2007/31B/00322/0059.

Declaration of interest: João Bernardes, Paulo Sousa and Diogo Ayres-de-Campos, were involved in the development of the Omniview-SisPorto® system. The Institute of Biomedical Engineering receives royalties from commercialization of the system, but these are solely used for the purpose of research and development.