Jallo Nancy, Bray Karen, Padden Megan Philpotts, Levin David
School of Nursing, Virginia Commonwealth University, Richmond, Virginia 23298, USA.
J Perinat Neonatal Nurs. 2009 Jul-Sep;23(3):241-50. doi: 10.1097/JPN.0b013e3181af85ec.
Preterm birth (PTB) is one of the most acute problems in obstetrics today. It is recommended that quality measures related to the prevention and management of PTB be identified and implemented for systems of clinical care. With its professional commitment to women and families, nursing is positioned to play an important role in this professional issue of quality improvement. A nursing team joined forces with a managed care organization to develop and implement a quality program to improve perinatal outcomes for pregnant women enrolled in the managed care organization. The team integrated a holistic framework, the best evidence, their clinical expertise, and the pregnant member's values and concerns. Using a pre/postprogram implementation design, perinatal outcomes in terms of neonatal intensive care length of stay were improved, with resultant cost savings. The improvement of these proxy measures for the health of the infant is an initial step in the reduction of PTB.
早产是当今产科领域最严峻的问题之一。建议针对临床护理系统确定并实施与早产预防和管理相关的质量措施。凭借其对妇女和家庭的专业承诺，护理工作在这个质量改进的专业问题中能够发挥重要作用。一个护理团队与一家管理式医疗组织合作，制定并实施了一项质量计划，以改善加入该管理式医疗组织的孕妇的围产期结局。该团队整合了一个整体框架、最佳证据、他们的临床专业知识以及怀孕成员的价值观和关切事项。采用项目实施前/后的设计，新生儿重症监护住院时间等围产期结局得到改善，同时节省了成本。改善这些婴儿健康的替代指标是降低早产率的第一步。
