Page 40 - Q BULLETIN, Ministry of Health Malaysia, VOLUME 1, NO. 31 (SUPPLEMENT 1), JAN-DEC 2022

Q Bulletin, Volume 1, No. 31 (Supplement 1), Jan - Dec 2022
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11 National QA Convention, 4 – 6 October 2022
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Increasing the Percentage of Postnatal Modified Glucose Tolerance Testing (MGTT)
among Patients with Gestational Diabetes Mellitus in Klinik Kesihatan Sitiawan

Nurasidah R¹, Mimi A¹, Halimatun S², Noorasmeda A³
¹ Klinik Kesihatan Sitiawan, Perak
² Klinik Kesihatan Pantai Remis, Perak
³ Pejabat Kesihatan Daerah Manjung, Perak

SELECTION OF OPPORTUNITIES FOR IMPROVEMENT:
Post-natal diabetic screening among patients with Gestational Diabetes Mellitus (GDM) is low in Klinik
Kesihatan Sitiawan. In 2019 only 78.9% GDM patients had postnatal MGTT. This may lead to late detection
of Diabetes Mellitus and complications. This study aims to increase the percentage of post-natal MGTT among
GDM patients in Klinik Kesihatan Sitiawan.

KEY MEASURES FOR IMPROVEMENT:
The indicator is the percentage of post-natal MGTT done at 6-8 weeks post-natal period. The standard is 100%.

PROCESS OF GATHERING INFORMATION:
This is a cross-sectional study using universal sampling. Sample sizes during the pre-remedial phase
(1/7/2020-31/12/2020) and post-remedial phase (1/7/2021-31/12/2021) were 148 and 139, respectively. Data
on determining the contributing factors, including knowledge among patients and staff, documentation and
time factor, were collected using questionnaires and reviewed antenatal records.

ANALYSIS AND INTERPRETATION:
Pre-intervention, only 88.6% of GDM patients underwent post-natal MGTT. Contributing factors identified
were poor knowledge (27.7%), misperceptions of MGTT as time-consuming amongst GDM patients (71.0%),
poor knowledge and misunderstood the importance of a timely MGTT amongst staff (27.5%).

STRATEGIES FOR CHANGE:
Training sessions and monthly card audits were carried out to improve the knowledge among staff. Health
education to GDM patients was given during antenatal and post-natal to enhance knowledge and awareness. A
reminder system and defaulter tracing were implemented for better compliance. Fast registration helps shorten
the MGTT procedure. Health education includes sharing information regarding MGTT using website links
with infographics.

EFFECT OF CHANGE:
The percentage of post-natal MGTT among GDM patients during the post-remedial phase had increased to
100%. Improving knowledge and increased awareness among patients helps achieve the target. Health education
includes sharing information regarding MGTT using website links with infographics. Post remedially, only
29% of patients perceived MGTT as time-consuming.

THE NEXT STEP:
The Quality Assurance (QA) study’s strategies will be replicated in other health clinics in Manjung.

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