In March 2023, PCMCH completed the evaluation of the Safe Administration of Oxytocin project in Ontario. A multi-pronged approach was used to determine the degree of uptake, effectiveness and utility of the Safe Administration of Oxytocin recommendations and tools. This included input from birthing hospitals, maternal-child health regional networks and data from Ontario’s Better Outcomes & Registry Network (BORN).
Feedback was captured directly from birthing hospitals through a survey with nearly a third of the province (n=28) participating. All participating hospitals reported safe use of oxytocin as a high priority area for their sites. Hospitals that are implementing this work (n=23) stated that they apply nearly all the PCMCH recommendations in their institution to some degree. Supportive leadership, interprofessional collaboration and ease of use were noted as the most significant enablers for implementation.
The largest barriers to implementation reported by hospitals were related to the COVID-19 pandemic. Three out of the six maternal-child regional health networks that implemented this work reported similar enablers and challenges, particularly in relation to the pandemic and its impact on health human resources. Data from BORN was used to determine the impact of this project on clinical outcomes. The pandemic may have also influenced this aspect of the evaluation. For example, one indicator investigates the percentage of eligible pregnant individuals induced or augmented with oxytocin who had a vaginal birth; however, the pandemic may have lowered clinician threshold in calling for a caesarean section. This would allow for limited interpretation on the relationship between oxytocin use and decrease in rates of caesarean section. The data will continue to be monitored over time.
Notable Successes from Hospital Surveys
"Empowerment for staff nurses and patient. Education has increased for patients, and staff feel more supported having clear guidelines for oxytocin administration.”
"We now have excellent compliance with safety monitoring and administration. Smart pumps used universally for oxytocin and only low-dose protocols being used. An overall success.”
"We recently celebrated two years of no oxytocin errors post-implementation, from June 2020 to September 2022.”
For more information regarding the evaluation findings, please contact info@pcmch.on.ca.