Department of Women and Child, University Hospitals Leuven, Belgium.
J Adv Nurs. 2013 Feb;69(2):278-85. doi: 10.1111/j.1365-2648.2012.06004.x. Epub 2012 Apr 11.
To report a study to determine whether or not variations exist in evidence-based key interventions in pathway documents for normal delivery across hospitals.
Care pathways are used worldwide to standardize and follow up patient-focused care. Minimal variations in pathway documents increase standardization and patient safety.
A descriptive study design using qualitative methods was used, to examine the various key interventions present in care pathway documents for normal delivery.
Between January-March 2009, we evaluated the content of the care pathway document for normal delivery from 17 different hospitals. The key interventions in these pathways were compared with the 40 evidence-based key interventions of Map of Medicine®.
There was much variation in the characteristics and the presence of key interventions in the pathway documents. Only 6 of the 40 evidence-based key interventions (15%) were found in all 17 pathway documents and 20 of the 40 interventions (50%) were found in only 10 pathway documents.
If variation already exists among the care pathway documents, this may lead to a high probability of variation in the actual performance of daily care. In this study is shown that, even for highly predictable medical conditions, there are huge differences in the evidence-based content and structure of pathways. Lack of evidence base could potentially endanger both patient safety and the health professional.
报告一项研究，以确定医院间正常分娩路径文件中的循证关键干预措施是否存在差异。
护理路径在全球范围内用于标准化和跟进以患者为中心的护理。路径文件中最小的差异可以提高标准化和患者安全性。
采用描述性研究设计和定性方法，检查正常分娩护理路径文件中存在的各种关键干预措施。
在 2009 年 1 月至 3 月期间，我们评估了来自 17 家不同医院的正常分娩护理路径文件的内容。将这些路径中的关键干预措施与 Map of Medicine®的 40 项循证关键干预措施进行了比较。
路径文件中的特征和关键干预措施存在很大差异。只有 40 项循证关键干预措施中的 6 项（15%）出现在所有 17 个路径文件中，而 40 项干预措施中的 20 项（50%）仅出现在 10 个路径文件中。
如果护理路径文件之间已经存在差异，这可能导致日常护理实际执行中的差异概率很高。本研究表明，即使对于高度可预测的医疗状况，路径的循证内容和结构也存在巨大差异。缺乏循证基础可能会对患者安全和卫生专业人员的健康构成潜在威胁。
