Maternal and Newborn Health Unit, Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
Midwifery. 2012 Oct;28(5):e676-83. doi: 10.1016/j.midw.2011.09.003. Epub 2011 Oct 20.
to review published papers and reports examining quality of care in maternal and newborn health to identify definitions and models of quality of care.
literature review.
electronic search of MEDLINE and organisational databases for literature describing definitions and models of quality used in health care and maternal and newborn health care. Relevant papers and reports were reviewed and summarised.
there is no universally accepted definition of quality of care. The multi-faceted nature of quality is widely acknowledged. In the literature quality of care is described: from the perspective of health care providers, managers and patients; dimensions within the health care system; using elements such as safety, effectiveness, patient-centeredness, timeliness, equity and efficiency; and through the provision of care and experience of care.
the importance of ensuring good quality of care for women and newborn babies is well recognised in the literature, however, there is currently no agreed single and comprehensive definition described. Several models were identified, which can be combined to form a comprehensive framework to help define and assess quality of care or lack of quality. Approaches to quality of care that are specifically important for maternal and newborn health were identified and include a rights based approach, adopting care that is evidence-based, consideration of the mother and baby as interdependent and the fact that pregnancy is on the whole a healthy state.
a model of quality of maternal and newborn health care using perspectives, characteristics, dimensions of the system and elements of quality of care specific to maternal and newborn health is proposed, which can be used as a basis for developing quality improvement strategies and activities, and incorporating quality into existing programmes.
回顾已发表的文献和报告，以检查母婴健康护理中的护理质量，确定护理质量的定义和模式。
文献回顾。
在 MEDLINE 和组织数据库中进行电子检索，以查找描述医疗保健和母婴保健中使用的质量定义和模式的文献。对相关文献进行了审查和总结。
目前没有普遍接受的护理质量定义。质量的多面性已被广泛认可。在文献中，护理质量从医疗保健提供者、管理者和患者的角度来描述；在医疗保健系统内的各个方面；使用诸如安全性、有效性、以患者为中心、及时性、公平性和效率等要素；并通过提供护理和护理体验来描述。
文献中充分认识到确保妇女和新生儿获得良好护理质量的重要性，但目前尚未描述出一个被广泛认可的单一且全面的定义。已经确定了几种模式，可以将它们组合起来形成一个全面的框架，以帮助定义和评估护理质量或缺乏质量的情况。确定了对母婴健康特别重要的护理质量方法，包括基于权利的方法、采用基于证据的护理、考虑母婴之间的相互依存关系，以及怀孕总体上是一种健康状态。
提出了一种使用母婴健康特定的视角、特点、系统维度和护理质量要素的母婴健康护理质量模型，可作为制定质量改进策略和活动的基础，并将质量纳入现有方案。
