Preventing Retention of Vaginal Packing in Obstetrics: Implementation of a Protocol to Improve Patient Safety

Background: Retained vaginal packing can be associated with serious psychological and physical complications.The purpose of this study was to enhance patient safety by implementing an obstetrical vaginal packing protocoland to evaluate its efficacy. The study occurred in a tertiary maternity center with roughly 6,000 deliveries a year.Methods: A vaginal packing protocol was instituted. The protocol added a “vaginal packing” button to the electronichealth record that subsequently prompted a notification to remove and document removal of the packing. A retrospectivechart review of compliance with the protocol was performed on all deliveries that occurred during a 1-year periodafter implementation.Results: Of the 6,118 deliveries, 92% (5625/6117) completed the vaginal packing section of the delivery summary.Vaginal packing was placed in 1% (63/5625) of the deliveries in which the delivery summary was completed. A notedocumenting removal of the packing occurred in 73% (46/63) of the deliveries. There were no cases of retainedvaginal packing.Conclusions: This is an effective and sustainable protocol to prevent retention of vaginal packing. This process couldbe adopted in the gynecologic setting and among many hospitals.