PERINATAL PATIENT SAFETY COLUMN: New Standards for Maternal Safety in Birthing Hospitals

摘要

The Joint Commission released information in August 2019 about new standards to keep mothers safe during childbirth that will be effective July 1, 2020, for their accredited hospitals. These standards are in response to alarming statistics about maternal mortality in the United States (Centers for Disease Control and Prevention [CDC], 2018; Petersen et al., 2019) and review of the literature on strategies that may be effective in minimizing risk of preventable maternal deaths. Expert panels of nurses, midwives, and physicians convened by the Joint Commission were involved in their development. Approximately 700 women die each year in the United States from pregnancy-related complications, according to the CDC (Petersen et al., 2019). From 2011 to 2015, there were 3,410 pregnancy-related deaths in the United States; the overall pregnancy-related maternal mortality ratio was 17.2 pregnancy-related deaths per 100,000 live births. Opportunities for improvement in care of pregnant women have been identified in several large studies of severe maternal morbidity (near-miss maternal mortality) and maternal deaths (Building U.S. Capacity to Review and Prevent Maternal Deaths, 2018; Ozimek et al., 2016). Using the definition of preventable death as "if the committee determines that there was some chance of the death being averted by one or more reasonable changes to patient, community, provider, health facility, and/or system factors" (Petersen et al., p. 2), about 60% of pregnancy-related deaths evaluated by state maternal mortality review committees were identified as preventable. Leading causes of maternal deaths were cardiovascular conditions (>33%), noncardiovascular medical conditions (14.3%),infection(12.5%), and obstetric hemorrhage (11.2%).