一个三级护理教学医院的下级病房的袋鼠母婴护理利用率:质量改善研究
Dipen V Patel1, K Sameer1, Reshma K Pujara1
1Department of Neonatology, Pramukhswami Medical College, Bhaikaka University, Karamsad, Anand, Gujarat 388325, India.
Journal of tropical pediatrics
|November 25, 2023
概括
印度面临着高额早产和低出生体重婴儿的负担. 一项质量改进研究成功地将袋鼠母亲护理 (KMC) 覆盖率提高到100%,每天使用时间超过5小时.
科学领域:
- 新生儿护理 新生儿护理
- 公共卫生干预措施 公共卫生干预措施
- 质量改进科学 质量改进科学
背景情况:
- 印度的早产和低出生体重新生儿的全球负担最高.
- 袋鼠母亲护理 (KMC) 是改善这些脆弱婴儿的结果的重要干预措施.
- 扩大KMC对于解决印度新生儿死亡率和发病率至关重要.
研究的目的:
- 实施和评估质量改进 (QI) 计划,以将KMC覆盖率提高到80%,并将使用时间提高到至少4小时/婴儿/天.
- 识别和克服在第三级护理环境中有效实施KMC的障碍.
主要方法:
- 一项为期4个月的QI研究在第三级护理教学机构的KMC病房中进行.
- 干预措施包括每日KMC小时记录,持续的护理支持和加强家长教育,通过Plan-Do-Study-Act (PDSA) 周期进行测试.
- 使用鱼骨分析来确定KMC实施的潜在障碍.
主要成果:
- 在研究结束时,KMC覆盖率从基线的50%增加到100%,并且持续存在.
- 在符合条件的婴儿中,KMC的利用率从18.8%的患者日增加到维持阶段的88.96%.
- 平均KMC利用率从基线时的1.97小时/婴儿/天显著增加到维持阶段的5.65小时/婴儿/天.
结论:
- 质量改进举措,特别是使用PDSA周期的举措,有效地显著改善了KMC覆盖率和利用率.
- 通过针对医疗保健提供者和家庭的系统干预,可以通过成功扩大KMC的规模.
- 增强的KMC实践有助于在高负担环境中更好地照顾早产和低出生体重新生儿.
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