在住院产后病房的妇女中,产后出血的预防和管理:一个最佳实践实施项目
Debi Lane Fatherree1,2, Michelle Palokas1,2
1School of Nursing, University of Mississippi Medical Center, Jackson, MI, USA.
JBI evidence implementation
|November 15, 2023
概括
实施基于证据的实践显著改善了产后出血预防和管理. 临床审计和员工模拟在住院产后病房的遵守率从84%提高到98%.
科学领域:
- 产科和妇科 产科和妇科
- 基于证据的医疗保健
- 改善医疗保健的质量
背景情况:
- 产后出血 (PPH) 占母亲死亡的90%,其中50%是可以预防的.
- 密西西比大学医学中心 (UMMC) 面临高风险分娩,最近的PPH事件突出了实践改进的需要.
- 3 Wiser部门确定了加强PPH预防和管理协议的机会.
研究的目的:
- 在3 Wiser部门内促进PPH预防和管理的基于证据的实践.
- 改善临床结果,减少与PPH相关的孕产妇发病率和死亡率.
- 在高风险的产科环境中评估证据实施项目的有效性.
主要方法:
- 利用乔安娜·布里格斯研究所 (JBI) 基于证据的医疗保健模型和JBI临床证据系统的实际应用.
- 采用JBI将研究转化为实践的审计和反策略来指导该项目.
- 对四种选择的基于证据的PPH管理实践进行了基线和后续审计.
主要成果:
- 基线审计显示,所选基于证据的实践的平均合规率为84%.
- 干预包括员工模拟和政策/技能审查,重点是PPH管理.
- 实施后的审计显示,平均合规率大幅增加至98%,改善了14%.
结论:
- 证据实施项目成功增强了PPH预防和管理的临床实践.
- 临床审计是推动产科单位实践变革的有效工具.
- 改善对基于证据的实践的遵守,可以在PPH护理中带来更好的患者结果.
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