Utilization of safe obstetrics anesthesia protocol and associated factors among anesthesia providers during elective and emergency cesarean section in Jimma University Medical Center

Abstract

Background: Anesthesia is one among the medical specialties which have sought to boost the standard of health care and patient safety by setting standards for safe practice in anesthesia that were adopted by the globe Federation of Societies of Anesthesiologists (WFSA). A fundamental assumption is that, to scale back maternal mortality, there should be rapid access to effective emergency obstetric and anesthesia care. The wants for safe practice of obstetric anesthesia are as follows: Skills within the variety of adequately trained staff and academic resources, appropriate anesthesia monitors, disposables and medicines, relevant management protocols for every level of care, with supervision and audit. Gaps in utilization can arise from unavailability of resources and from an inability to use available resources which can arise from lack of expertise. Objective: The purpose of the study was to assess the level of utilization of the safe obstetrics anesthesia protocol among anesthesia providers during elective and emergency cesarean section in Jimma university medical center. Methods: An institution based cross-sectional study of anesthesia providers during elective and emergency cesarean section in Jimma university medical center, using a structured interviewer administered questionnaire, by trained anesthesia assistants. All anesthesia providers working at Jimma University medical center and fulfill the inclusion criteria were included in the study. Data entry was done using Epi data manager (Version 4.6.0.2). SPSS version 26 was used for analysis. Descriptive analysis was used to summarize the relationship between the independent variables and dependent variable. Chi-square test was used to test for the presence or absence of association Results: Among 70 anesthesia service providers in the hospital, 60 participated. The response rate was 100%. Forty eight (80%) were within the age range of 25-35 years. 48(78.3%) were male. Regarding duration of experience and professional training, 30(50%) had experience of 2- 5years and was residents. Four parameters were used to assess the level of utilization of safe obstetrics anesthesia protocol. Accordingly, 51(85%), 43(71.7%), 43(78.3%) and 28(46.7%) had good utilization of safe obstetric anesthesia protocol in availability of medications and intravenous fluids, conduct of anesthesia and Availability of monitoring device respectively. In 3 this study, the level of good utilization of safe obstetric anesthesia protocol was 41 (68.3%), 95% CI [68.2, 68.4]. Chi square test was employed and it showed strong statistical associations between good utilization of safe obstetrics anesthesia protocol and availability of facility and equipment (Pearson’s X 2 =10.8, P-value=0.001), availability of medication and intravenous fluids (Pearson’s X 2 =5.99, P-value=0.014), availability of monitoring device (Pearson’s X 2 =4.66, P value=0.031) and conduct of anesthesia (Pearson’s X 2 =16.6 P value=0.0001) respectively. However, there were no associations between utilization of good utilization of safe obstetrics anesthesia protocol and gender, age, level of experience or professional training. Conclusion: The study revealed a higher good level of utilization of safe obstetric anesthesia protocol. The factors associated with good utilization of safe obstetric anesthesia protocol were; availability of medication and IV fluid, Conduct of anesthesia, availability of monitoring device, facility and equipment