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实施早产监测PAthway:一个现实的评估 (IMPART研究)
Naomi Carlisle1, Sonia Dalkin2, Andrew H Shennan3
1Department of Women and Children's Health, The School of Life Course & Population Sciences, King's College London, 10th Floor North Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK. naomi.h.carlisle@kcl.ac.uk.
该IMPART研究发现,改善早产路径的实施需要教育临床医生,建立多学科团队,并加强当地网络合作,以更好地预防早产.
科学领域:
- 实施科学 实施科学
- 孕产妇健康 孕产妇健康
- 公共卫生政策 公共卫生政策
背景情况:
- 英国面临着高早产率 (7.6%),国家目标是到2025年将其降至6%.
- 英格兰NHS的"拯救婴儿生命护理包"第2版第5元素建议在危险妇女的早产路径.
- 这一途径的成功实施对于实现国家早产减少目标至关重要.
研究的目的:
- 通过使用现实的评估方法调查早产监测途径的实施情况.
- 了解影响早产预测和预防的上下文因素.
- 确定改善该途径有效性和覆盖范围的机制.
主要方法:
- 通过文献审查,专家采访和全国调查,开发了最初的程序理论.
- 利用实现理论来指导理论的发展.
- 通过采访和观察在三个英语案例网站收集数据来测试和完善理论.
- 在数据分析中使用实质理论进行解释和改进策略.
主要成果:
- 确定了三个关键的解释领域:风险评估/转诊,早产监测诊所功能和以女性为中心的护理.
- 在准确的风险评估和转介过程中突出挑战.
- 强调知识博,得到支持的临床医生和运作良好的诊所对于有效监测的重要性.
- 专注于该途径如何确保适当和以女性为中心的护理服务.
结论:
- 实施的改进包括加强临床医生关于风险因素和临床目的的教育.
- 倡导拥有专业技能的多学科早产团队,包括通过阴道进行宫扫描.
- 强调需要网站及其本地网络之间积极合作.
- 建议继续照顾高风险妇女,尊重她们的病史,而不是根据风险状况来定义她们.
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