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Midwives’ Adherence to Preoperative Care Guidelines Prior to Emergency Caesarean Section at Bwaila Maternity Hospital in Malawi

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DOI: 10.4236/ojn.2014.411081    3,786 Downloads   4,372 Views   Citations


A study was conducted to describe midwives’ adherence to preoperative care during emergency caesarian section at Bwaila Maternity Wing in 2012 in Malawi. The study utilized a descriptive prospective and retrospective design. A structured questionnaire was administered to all 28 midwives who were directly involved in the preparation of clients for emergency caesarean section. Clients charts were also reviewed using a standard checklist to determine adherence to preoperative care. Data were analyzed using SPSS version 16.0 and descriptive statistics in the form of frequencies and percentages were computed for the dataset. A midwife was supposed to score at least 80% on each component of preoperative care guidelines to be compliant to the stipulated pre-operation standards. The midwives scored above 80% on only four of the 14 preoperative care guidelines which were; bladder catheterization (100%, n = 14), obtaining informed consent (92.9%, n = 12), administration of IV (96.4%, n = 13) and administration of preoperative antibiotics (82.1%, n = 11). Midwives however scored less than 80% on preoperative procedures that dealt with vital signs (28.6%, n = 4): BP check (28.6%, n = 4); Pulse rate check (25%, n = 3.5); respiration check (25%, n = 3.5) and temperature check (25%, n = 3.5). The midwives scored further below standard on blood specimen collection (78.6%, n = 11). Psychological support to clients was also below standard at 60.7%, n = 8. Other components of psychological support such as surgery information (57.1%, n = 8), allowing clients ask questions (28.6%, n = 4) and answering clients’ questions (25%, n = 3.5) were also scored below standard. Overall the standard of preoperative care was below standard at the facility. Most of the midwives were new graduates, who had never received any in-service training on preoperative care. Therefore in service training it is recommended for the midwives to provide good quality of care.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Mwale, R. , Maluwa, A. , Malata, A. and Odland, J. (2014) Midwives’ Adherence to Preoperative Care Guidelines Prior to Emergency Caesarean Section at Bwaila Maternity Hospital in Malawi. Open Journal of Nursing, 4, 754-761. doi: 10.4236/ojn.2014.411081.


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