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通过在社区医院增加有效的产妇护理来减少初级剖腹产
Teresa L Reagan1, Sybilla Myers2
1Frontier Nursing University, Lexington, KY, USA.
通过在入院时识别母亲,并在分娩期间提供有效的护理,可以减少无卵性剖腹产的出生率. 这项质量改进项目成功减少了7%的无胎儿,满期,单胎和顶部 (NTSV) 剖腹产.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇健康 孕产妇健康
- 提高医疗保健的质量 改善医疗保健的质量
背景情况:
- 无卵性剖腹产产率仍然很高,对严重的孕产妇发病率和医疗保健成本的增加做出了重大贡献.
- 剖腹产与更长的住院时间,新生儿重症监护室入院和产后并发症有关.
- 一个特定的社区医院观察到,在2022年,无胎,终身,单胎和顶胎 (NTSV) 怀孕中,剖腹产产的增加近3%.
研究的目的:
- 在社区医院减少NTSV剖腹产的发生率.
- 通过质量改进计划,提高80%的未婚妇女的有效产妇护理.
- 实施和评估一个快速循环质量改进项目,使用"计划-做-研究-行动"模式.
主要方法:
- 一个快速循环质量改进项目在8周内进行,利用计划-做-研究-行动模型的4个2周周期.
- 关于母亲查和有效护理的数据每隔一天收集一次,每两周分析一次.
- 干预措施包括一个患者查工具来识别无产妇的母亲和一个有效的护理清单来指导劳动管理.
主要成果:
- 该项目对215名母亲进行了81%的查,确定了116名无产妇.
- 在实施检查清单后,平均有效的孕产妇护理得分达到84%.
- 通过实施的干预措施,NTSV剖腹产出生率减少了7%.
结论:
- 在入院时识别无产妇母亲,并提供有效的分娩护理,可以显著降低NTSV剖腹产出生率.
- 开发的查和检查清单工具可能适用于所有分娩母亲,以进一步减少剖腹产.
- 这项质量改进项目证明了在社区医院环境中降低剖腹产产率的成功策略.
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