Wiegers Therese A, Warmelink J Catja, Spelten Evelien R, Klomp T, Hutton Eileen K
NIVEL (Netherlands Institute for Health Services Research), P.O. Box 1568, 3500 BN Utrecht, The Netherlands.
Midwifery Academy Amsterdam Groningen, The Netherlands; Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands.
Midwifery. 2014 Sep;30(9):991-7. doi: 10.1016/j.midw.2013.08.010. Epub 2013 Aug 27.
to re-assess the work and workload of primary care midwives in the Netherlands.
in the Netherlands most midwives work in primary care as independent practitioners in a midwifery practice with two or more colleagues. Each practice provides 24/7 care coverage through office hours and on-call hours of the midwives. In 2006 the results of a time registration project of primary care midwives were published as part of a 4-year monitor study. This time the registration project was repeated, albeit on a smaller scale, in 2010.
as part of a larger study (the Deliver study) all midwives working in 20 midwifery practices kept a time register 24 hours a day, for one week. They also filled out questionnaires about their background, work schedules and experiences of workload. A second component of this study collected data from all midwifery practices in the Netherlands and included questions about practice size (number of midwives and number of clients in the previous year).
in 2010, primary care midwives actually worked on an average 32.6 hours per week and approximately 67% of their working time (almost 22 hours per week) was spent on client-related activities. On an average a midwife was on-call for 39 hours a week and almost 13 of the 32.6 hours of work took place during on-call-hours. This means that the total hours that an average midwife was involved in her work (either actually working or on-call) was almost 59 hours a week. Compared to 2004 the number of hours an average midwife was actually working increased by 4 hours (from 29 to 32.6 hours) whereas the total number of hours an average midwife was involved with her work decreased by 6 hours (from 65 to 59 hours). In 2010, compared to 2001-2004, the midwives spent proportionally less time on direct client care (67% versus 73%), although in actual number of hours this did not change much (22 versus 21). In 2009 the average workload of a midwife was 99 clients at booking, 56 at the start of labour, 33 at childbirth, and 90 clients in post partum care.
the midwives worked on an average more hours in 2010 than they did in 2004 or 2001, but spent these extra hours increasingly on non-client-related activities.
重新评估荷兰初级护理助产士的工作及工作量。
在荷兰，大多数助产士作为独立从业者在初级护理领域工作，所在助产士诊所通常有两名或更多同事。每个诊所通过助产士的办公时间和值班时间提供全天候护理服务。2006年，一项初级护理助产士时间登记项目的结果作为一项为期4年的监测研究的一部分得以公布。此次，该登记项目于2010年再次开展，不过规模较小。
作为一项更大规模研究（分娩研究）的一部分，在20家助产士诊所工作的所有助产士连续一周每天24小时记录时间。他们还填写了有关其背景、工作时间表和工作量体验的问卷。该研究的第二个部分收集了荷兰所有助产士诊所的数据，包括有关诊所规模（助产士人数和上一年的客户数量）的问题。
2010年，初级护理助产士实际平均每周工作32.6小时，其工作时间的约67%（每周近22小时）用于与客户相关的活动。平均而言，一名助产士每周值班39小时，在32.6小时的工作时间中，近13小时是在值班时间内完成的。这意味着一名助产士参与工作的总时长（实际工作或值班）平均每周近59小时。与2004年相比，一名助产士实际工作的时长增加了4小时（从29小时增至32.6小时），而一名助产士参与工作的总时长减少了6小时（从65小时减至59小时）。2010年，与2001 - 2004年相比，助产士在直接客户护理上花费的时间比例有所减少（67%对73%），不过实际时长变化不大（22小时对21小时）。2009年，一名助产士的平均工作量为：预约时99名客户，临产前56名，分娩时33名，产后护理90名客户。
2010年助产士平均工作时长比2004年或2001年更多，但这些额外时间越来越多地用于与客户无关的活动。
