Clinical Audit of Postpartum Anti-D Immunoglobulin Administration in Rh-Negative Mothers

Objectives Clinical audit enables comparison of current practices with established standards and helps identify areas requiring improvement to enhance the quality of patient care. Concerns were raised regarding the appropriateness of postpartum anti-D prophylaxis, as a few cases of Rh isoimmunisation were observed despite administration of anti-D immunoglobulin. Therefore, this study aimed to evaluate whether postpartum anti-D immunoglobulin prophylaxis was appropriately administered to Rh-negative mothers delivering Rh-positive neonates and to assess the adequacy of documentation of its administration (timing, dose, route, and site). The study also aimed to identify deficiencies in documentation and to assess improvement following sensitisation of healthcare providers through a reaudit. Material and Methods A retrospective audit of case records was conducted over 2 years (January 2022 to December 2023) to assess the administration of postpartum anti-D prophylaxis and related documentation practices among Rh-negative mothers. Data were collected on documentation parameters, including timing, dosage, route, and site of administration. Following the initial audit, healthcare providers (postgraduates and consultants) were sensitised through interactive feedback sessions highlighting gaps in documentation. A prospective reaudit was then carried out over 6 months (January to June 2024) using the same parameters to evaluate the impact of the intervention. Results Among 5,403 deliveries, 190 Rh-negative mothers delivered Rh-positive neonates. Although prophylaxis was administered in all eligible cases, documentation was incomplete. Following sensitisation, the reaudit demonstrated 100% documentation of timing, dose, and route ( p ≤0.001), along with significant improvement in documentation of the site (81.82%, p <0.001). All doses were administered within 72 h of delivery. Conclusion Although postpartum anti-D immunoglobulin prophylaxis was administered appropriately, deficiencies were noted in documentation of timing, dose, route, and site. Following targeted sensitisation of healthcare providers, a significant improvement in documentation practices was observed in the reaudit. Clinical audit is an effective tool for identifying gaps in practice and improving the quality of patient care.