Bream Kent D W, Gennaro Susan, Kafulafula Ursula, Mbweza Ellen, Hehir David
Department of Family Practice and Community Medicine, University of Pennsylvania School of Medicine, 2 Gates HUP-3400 Spruce Street, Philadelphia, PA 19104, USA.
J Midwifery Womens Health. 2005 Jul-Aug;50(4):329-34. doi: 10.1016/j.jmwh.2005.04.006.
Newborn resuscitation is a key component of efforts to reduce neonatal morbidity and mortality. This article reports the findings of focus groups conducted to explore the barriers and facilitators present for obstetric nurse providers in a central urban hospital in Malawi regarding the training and provision of neonatal resuscitation. All obstetric nurse providers in this setting participated in focus groups; these groups identified 4 themes: 1) confidence in their skills in assessing newborns and recognizing the need for resuscitation, 2) a lack of resources, 3) facilitators who would enable them to introduce resuscitation, and 4) solutions to the current problems. Resource shortages and barriers to providing care included availability of staff, equipment, and supplies; labor ward geography; ethical dilemmas; and the lack of standard protocols regarding newborn resuscitation. Facilitators were professional experience and the critical load of deliveries performed. Solutions to barriers included small resource additions as well as long-term policy changes. With standard policy and protocols, experienced, confident nurses could overcome the barriers to providing newborn resuscitation. This group identified ways to change systems to decrease infant mortality, thereby improving the health and quality of life of women receiving care in Malawi.
新生儿复苏是降低新生儿发病率和死亡率工作的关键组成部分。本文报告了焦点小组的研究结果，该焦点小组旨在探讨马拉维一家市中心城市医院的产科护士在新生儿复苏培训和实施方面所面临的障碍和促进因素。该环境中的所有产科护士都参加了焦点小组；这些小组确定了4个主题：1）对其评估新生儿和识别复苏需求技能的信心，2）资源短缺，3）能够促使他们开展复苏工作的促进因素，4）当前问题的解决方案。资源短缺和提供护理的障碍包括人员、设备和物资的可用性；产房布局；伦理困境；以及缺乏关于新生儿复苏的标准规程。促进因素是专业经验和所进行分娩的关键负荷。障碍的解决方案包括少量资源增加以及长期政策变革。有了标准政策和规程，经验丰富、自信的护士可以克服提供新生儿复苏的障碍。该小组确定了改变系统以降低婴儿死亡率的方法，从而改善在马拉维接受护理的妇女的健康和生活质量。
