Table 2.

Indicators, their set targets and Action points following presentation of first audit results

Indicator	Currents status (At the initial audit)	Target (By the end of the second audit)	Action points during implementation	Contact Person and level of Achievement of target
Ω Blood grouping and cross matching for all patients prior to caesarean delivery	13 % had blood taken off	A target of 100 % was set.	Blood group & CBC were to be sent on.	Labour suite weekly rotation Team leader Target not achieved.
Bladder Catheterization Mothers to have urinary catheters inserted before delivery.	94 % of the mothers Preoperatively	100 % bladder catheterization pre-operatively.	Avail sundries. Avail Obstructed labour management protocol	Labour suite Area manager & Protocol team Protocol developed
Vital sign monitoring Done both on admission and at least once in 4 h in the labour ward.	15 % had a BP 17 % had their pulse rate measured No participant had a single temperature reading taken	100 % monitoring of vital signs (BP, PR, Temperature).	Midwives to take the vital signs CME was to be conducted The labour ward to be zoned into sections. .	Labour Suite in-charge CMEs conducted (achieved) Other targets not achieved

Ω Labour suite laboratory to process all the samples; Doctors and midwives to take off samples; Grouping and cross matching may be done in antenatal care to reduce delays