在斯里兰卡一家三级医疗机构实施世界卫生组织安全分娩检查表项目：一个发展中国家的经验
Implementation of the WHO safe childbirth checklist program at a tertiary care setting in Sri Lanka: a developing country experience.
作者信息
Patabendige Malitha, Senanayake Hemantha
机构信息
University Obstetrics Unit, De Soysa Hospital for Women, Colombo, Sri Lanka.
Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
出版信息
BMC Pregnancy Childbirth. 2015 Feb 4;15:12. doi: 10.1186/s12884-015-0436-0.
BACKGROUND
To study institutionalization of the World Health Organization's Safe Childbirth Checklist (SCC) in a tertiary care center in Sri Lanka.
METHOD
A hospital-based, prospective observational study was conducted in the De Soysa Hospital for Women, Colombo, Sri Lanka. Healthcare workers were educated regarding the SCC, which was to be used for each woman admitted to the labor room during the study period. A qualitatively pretested, self-administered questionnaire was given to all nursing and midwifery staff to assess knowledge and attitudes towards the checklist. Each item of the SCC was reviewed for adherence.
RESULTS
A total of 824 births in which the checklist used were studied. There were a total of births 1800 during the period, giving an adoption rate of 45.8%. Out of the 170 health workers in the hospital (nurses, midwives and nurse midwives) 98 answered the questionnaire (response rate = 57.6%). The average number of childbirth practices checked in the checklist was 21 out of 29 (95% CI 20.2, 21.3). Educating the mother to seek help during labor, after delivery and after discharge from hospital, seeking an assistant during labor, early breast-feeding, maternal HIV infection and discussing contraceptive options were checked least often. The mean level of knowledge on the checklist among health workers was 60.1% (95% CI 57.2, 63.1). Attitudes for acceptance of using the checklist were satisfactory. Average adherence to checklist practices was 71.3%. Sixty eight (69.4%) agreed that the Checklist stimulates inter-personal communication and teamwork. Increased workload, poor enthusiasm of health workers towards new additions to their routine schedule and level of user-friendliness of Checklist were limitations to its greater use.
CONCLUSIONS
Amongst users, the attitude towards the checklist was satisfactory. Adoption rate amongst all workers was 45.8% and knowledge regarding the checklist was 60.1%. These two factors are probably linked. Therefore prior to introducing it to a facility awareness about the value and correct use of the SCC needs to be increased, while giving attention to satisfactory staffing levels.
背景
在斯里兰卡的一家三级护理中心研究世界卫生组织安全分娩检查表（SCC）的制度化情况。
方法
在斯里兰卡科伦坡的德索伊萨妇女医院开展了一项基于医院的前瞻性观察性研究。对医护人员进行了关于SCC的培训，该检查表将在研究期间用于每一位入住产房的妇女。向所有护理和助产人员发放了一份经过定性预测试的自填式问卷，以评估他们对检查表的知识和态度。对SCC的每一项内容进行了依从性审查。
结果
共研究了824例使用检查表的分娩情况。在此期间共有1800例分娩，采用率为45.8%。医院的170名医护人员（护士、助产士和助产护士）中，98人回答了问卷（回复率 = 57.6%）。检查表中检查的分娩操作平均数量为29项中的21项（95%置信区间20.2，21.3）。对母亲在分娩期间、分娩后及出院后寻求帮助、分娩时寻求助手、早期母乳喂养、产妇感染艾滋病毒以及讨论避孕选择等内容的检查最少。医护人员对检查表的平均知识水平为60.1%（95%置信区间57.2，63.1）。对使用检查表的接受态度令人满意。检查表操作的平均依从率为71.3%。68人（69.4%）同意检查表促进了人际沟通和团队合作。工作量增加、医护人员对日常工作新增内容热情不高以及检查表的用户友好程度是其更广泛使用的限制因素。
结论
在使用者中，对检查表的态度令人满意。所有工作人员的采用率为45.8%，对检查表的知识掌握率为60.1%。这两个因素可能相互关联。因此，在将其引入医疗机构之前，需要提高对SCC价值和正确使用的认识，同时关注人员配备水平是否令人满意。
Zotero 插件