任务转移:改善早产风险妇女护理的关键方面
Laurence Nathalie Irene Frei1, Naomi Carlisle2, Zoe Manton3
1Maternity, Lewisham and Greenwich NHS Foundation Trust, London, UK freilaurence87@gmail.com.
临床分娩助产士可以比医生快两倍地评估可能出现的早产症状, 减少孕妇的焦虑. 然而,由于医生在出院前必须进行检查,整体等待时间保持不变.
科学领域:
- 妇产科
- 产妇和胎儿医学
- 提高医疗保健的质量
背景情况:
- 孕产妇分娩通常会延迟临床检查,因为可能出现早产 (TPTL) 和早产膜破裂 (PPROM).
- 这些延误给妇女带来焦虑,
研究的目的:
- 评估授权分拣助产士对患有TPTL/PPROM的妇女进行镜检查的影响.
- 减少患者等待时间,提高产妇分类的效率.
主要方法:
- 实施了一项"计划-做-研究-行动"质量改进项目.
- 预产分娩助产士接受培训,对早产 (<37周怀孕) 妇女进行眼镜检查.
- 通过助产士和医生进行初步评估的等待时间进行了比较.
主要成果:
- 预先由分组助产士进行评估的平均等待时间为67分钟,而医生等待的时间为127分钟 (p<0. 001).
- 在助产士评估组中,量化胎儿纤维素 (qfFN) 测试的速度明显更快.
- 从抵达到出院的总等待时间没有显著差异.
结论:
- 对于可能出现早产症状的妇女来说,分娩助产士提供更快的初步评估.
- 授权助产士可以加快对没有TPTL/PPROM的妇女的安慰.
- 整体分类等待时间需要进一步优化,因为医生审查仍然是出院的必要条件.
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