在多元化和贫困人口中协助阴道分娩后减少母亲感染
Megan Williamson1, Amy Newnham1, India Corrin1
1Birmingham City Hospital, Birmingham, UK.
BMJ open quality
|September 6, 2024
概括
在辅助性阴道分娩后实施预防性抗生素显著减少了孕产妇感染. 干预措施改善了抗生素的使用率,证明了可持续的实践变化,以提高产后护理和减少败血症风险.
科学领域:
- 产科和妇科 产科和妇科
- 预防传染病 预防传染病
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 产后孕产妇败血症是孕产妇死亡率和发病率的主要原因之一.
- 国家指导方针建议预防性抗生素用于辅助性阴道分娩,以减少感染.
- 当地对这一建议的实施情况各不相同,需要采取质量改善举措.
研究的目的:
- 为了加强在辅助性阴道分娩后的预防性抗生素的局部管理.
- 在英国NHS信托基金会减少产后母亲感染的发生率.
- 评估针对性干预措施对抗生素预防效果的影响.
主要方法:
- 一种混合方法的方法,涉及期刊俱乐部,结果介绍和指南更新.
- 在三个审计周期 (2020-2023) 中,从电子健康记录和出生登记册 (n=287) 收集回顾性数据.
- 对预防性抗生素的使用率和与干预相关的产后母亲感染率的分析.
主要成果:
- 在2021年12月至2023年7月期间,预防性抗生素的使用量从13.2%增加到90.7%.
- 当预防药物使用时 (18.2%) 的孕产妇感染率低于未使用时 (22.2%).
- 在分娩病房和剧院之间管理的最初差异得到了解决,到2023年在两个领域实现了>90%的遵守率.
结论:
- 一套简单的干预措施成功改善并维持了预防性抗生素使用的做法.
- 有针对性的质量改进工作可以有效地提高对基于证据的指导方针的遵守.
- 需要进一步的研究,以解决观察到的整体产后母亲感染率的逐渐增加,并探索其他风险因素.
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