Table 2 Changes made according to recommendations made in the previous audit

1.

An obstetrician, a resident and an intern were assigned to cover the eclampsia ward for 24 hours

2.

Urine dipsticks were purchased and made available in the ward

3.

A protocol for management of eclampsia and severe pre-eclampsia as well as steroid use was displayed in the ward

4.

Because records were often poor, commitment to proper recording and use of the partogram was emphasized

5.

Decision to surgery time to be shortened and a tracer method (a register) was designed to note the time of decision, time of transfer to theater and actual time of surgery to detect point of delay.

6.

Management of eclampsia or severe pre-eclampsia was emphasized to be started immediately on arrival and the treatment plan to be reviewed by specialist within two hours

7.

Laboratory tests (Full blood count, liver enzymes, urinalysis, and kidney function tests) were made routine for every patient admitted to the eclampsia ward