Problems in Birth

Registration

What is the National Standard?

Why is the data so important?

Joanne M. WesleyOffice of the State Registrar

Data Done Right! Currently there are 10 data items that are a

problem in Minnesota birth registration.

The National Center for Health Statistics requires all states to report data accurately with the fewest “unknowns” as possible .

NCHS sets the standard for an acceptable percentage of “unknowns”.

Understanding Data

Understanding what the data field is allows a birth registrar to identify that data item in the medical record.

When birth registrars understand the importance of each data field, why the information is needed and how it is used it increases the accuracy and quality of data.

Sometimes found in the medical record

Should be asked on the Mother’s Worksheet

NCHS Standard: 1.32 Minnesota: 1.45

1. Education of the Mother

Why Mother’s Education?

Because it tracks:

trends in completed family size

fertility rates by age group

maternal/child health outcomes by age

Last Normal Menses

2. Month / Day / 3. Year

Actual date is best but month/year is acceptable

May be found in medical record under prenatal care

Should be asked on the Mother’s Worksheet

Try not to file an unknown

NCHS Standard: Minnesota:Month…….5.64 10.67Day….....17.78 10.67Year........5.03 10.67

Why Date of Last Normal Menses?

Because it helps track:

Gestational age Pre-term – before 34 weeks Late pre-term – 34 to 37 weeks Full term – 38 to 41 weeks Post date – after 41 weeks

Gestational age is a key factor in infant outcomes

4. Tobacco Use5. Number of Cigarettes

Should be asked on the Mother’s Worksheet

Women often under report their tobacco use

Smoking may change during the pregnancy

Tobacco use: NCHS Standard: 1.00 Minnesota: 1.12

Number of Cigarettes: NCHS Standard: 4.76 Minnesota: 4.82

Why track tobacco use?Obvious risk factor in pregnancy

Because it tracks:

Adverse effects on infant outcomes Low birth weight Intrauterine growth retardation Miscarriage High infant mortality Negative consequences on the child’s long

term health and development

6. Alcohol Use

Should be asked on the Mother’s Worksheet

Women often under report their alcohol use Alcohol use may change during the pregnancy

Healthcare provider usually ask during prenatal care

NCHS Standard: 2.03 Minnesota: 2.24

Why Alcohol Use?Because it:

Alerts healthcare providers to possible adverse outcomes at birth and beyond

May allow for early screening and intervention for fetal alcohol spectrum disorder

7. Medical Risk Factors

Know about each risk factor

Learn where each risk factor is found in the prenatal record and medical record

Best practice is to ask if you don’t know

Try not to file an unknown

NCHS Standard: 1.00 Minnesota: 1.23

Why Medical Risk Factors?

Because:

Maternal and infant outcome are affected by pregnancy and medical risk factors

Documenting risk factors may allow for healthcare interventions and additional care

8. Complications of Labor

Know what the complications are

Know why they affect labor and birth

Know where data is located in the medical record

Best practice is to ask if you don’t know

Try not to file an unknown

NCHS Standard: 1.00 Minnesota: 1.28

Why Complications of Labor?

Because:

All complications have the potential to impact or significantly affect maternal and infant health

Accurate reporting will assist in research and planning for prevention

Helps in planning public health intervention that may improve quality of life

9. Congenital Anomalies

Know what congenital anomalies are

Know where data is located in the newborn medical record

Best practice is to ask if you don’t know

Try not to file an unknown

Some anomalies are repairable and some are not

NCHS Standard: 1.00 Minnesota: 1.44

Why Congenital Anomalies?

Because:

Congenital anomalies remain the leading cause of infant death

Congenital anomalies are under reported on the birth record.

Helps in planning public health intervention that may improve quality of life

Know what the “other” conditions are to add excellence to the data collection

10. Abnormal Conditions

Know what these conditions are

Know why they affect the newborn

Found in the newborn medical record

Best practice - ask if you don’t know

NCHS Standard: 1.00Minnesota: 1.32

Why Abnormal Conditions?

Because:

Abnormal condition may impact the child’s health and development

Helps in planning public health intervention that may improve quality of life

Know what the “other” conditions are to add excellence to the data collection

Improvements

Number of Data Categories above the

National Standard

2006 - 14 data items 2007 - 13 data items 2008 - 13 data items 2009 - 10 data items

Each year you get closer to meeting all the data standards set by NCHS.

Public Health Implications

More accurate, comprehensivereporting on the birth record

will enhance our ability toanalyze and track crucial

indicators of maternal child health, including demographic

characteristics, healthcare utilization and outcomes.

Data Quality

“Excellence is in the details.

Give attention to the details and

excellence will come.”

Thank you for the work you do!