助产士领导的质量改进:在乌干达,增加使用基于证据的分娩实践
Johanna Blomgren1, Helena Lindgren2, Dinah Amongin3
1Department of Women's and Children's Health, Karolinska Institutet, Tomtebodavägen 18A, Stockholm, Solna 171 77, Sweden.
助产士主导的质量改进计划成功地弥补了母亲和新生儿医疗保健的证据与实践差距. 这些干预措施显著增加了基本的,基于证据的助产士实践的采用,改善了整体护理质量.
科学领域:
- 孕产妇和新生儿的健康
- 提高质量 提高科学 提高质量
- 助产士的实践 助产士的实践
背景情况:
- 解决证据与实践之间的差距对于产妇和新生儿健康结果至关重要.
- 助产士主导的质量改善干预措施,以弥合这一差距的研究不足.
- 在乌干达一家医院中发现了助产士实践中的差距,需要进行临床改进.
研究的目的:
- 增加基本的,基于证据的助产士实践的普及.
- 实施由助产士领导的质量改进 (QI) 方法.
- 解决在孕产妇医疗保健中发现的证据与实践的差距.
主要方法:
- 一个为期七个月的助产士领导的QI干预,使用计划-做-学习-行动 (PDSA) 周期.
- 专注于动态的出生位置,参与决策,围保护和产后支持.
- 培训培训师的方法和每周在线支持会议,为703名没有并发症的孕妇提供支持.
主要成果:
- 在所有有针对性的基于证据的实践中观察到显著的改善.
- 动态出生位置的使用率从0%增加到79%.
- 产内支持从7%增加到67%,其他实践也显示出实质性的收益.
结论:
- 助产士领导的QI举措可以带来对孕产妇和新生儿医疗的持续改善.
- 赋予助产士领导QI的权力,有效地缩小了证据与实践之间的差距.
- 需要有效的战略来提高护理质量,并促进基于证据的助产士.
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