Helsloot Kaat, Walraevens Mieke, Besauw Saskia Van, Van Parys An-Sofie, Devos Hanne, Holsbeeck Ann Van, Roelens Kristien
Faculty of Medicine & Health Sciences, Ghent University,Boskant 6, 9790 Elsegem, Belgium.
Faculty of Medicine & Health Sciences, Ghent University, Verrebeke 8, 9660 Belgium.
Midwifery. 2017 May;48:60-68. doi: 10.1016/j.midw.2017.02.008. Epub 2017 Feb 28.
to develop a set of quality indicators for postnatal care after discharge from the hospital, using a systematic approach.
key elements of qualitative postnatal care were defined by performing a systematic review and the literature was searched for potential indicators (step 1). The potential indicators were evaluated by five criteria (validity, reliability, sensitivity, feasibility and acceptability) and by making use of the 'Appraisal of Guidelines for Research and Evaluation', the AIRE-instrument (step 2). In a modified Delphi-survey, the quality indicators were presented to a panel of experts in the field of postnatal care using an online tool (step 3). The final results led to a Flemish model of postnatal care (step 4).
Flanders, Belgium PARTICIPANTS: health care professionals, representatives of health care organisations and policy makers with expertise in the field of postnatal care.
after analysis 57 research articles, 10 reviews, one book and eight other documents resulted in 150 potential quality indicators in seven critical care domains. Quality assessment of the indicators resulted in 58 concept quality indicators which were presented to an expert-panel of health care professionals. After two Delphi-rounds, 30 quality indicators (six structure, 17 process, and seven outcome indicators) were found appropriate to monitor and improve the quality of postnatal care after discharge from the hospital. KEY CONCLUSIONS AND IMPLICATIONS FOR CLINICAL PRACTICE: the quality indicators resulted in a Flemish model of qualitative postnatal care that was implemented by health authorities as a minimum standard in the context of shortened length of stay. Postnatal care should be adjusted to a flexible length of stay and start in pregnancy with an individualised care plan that follows mother and new-born throughout pregnancy, childbirth and postnatal period. Criteria for discharge and local protocols about the organisation and content of care are essential to facilitate continuity of care.
采用系统方法制定一套出院后产后护理质量指标。
通过系统评价确定定性产后护理的关键要素，并检索文献以寻找潜在指标（步骤1）。利用“研究与评价指南评估”（AIRE工具），依据五个标准（有效性、可靠性、敏感性、可行性和可接受性）对潜在指标进行评估（步骤2）。在改良的德尔菲调查中，使用在线工具将质量指标呈现给产后护理领域的专家小组（步骤3）。最终结果形成了弗拉芒产后护理模式（步骤4）。
比利时弗拉芒地区
产后护理领域的医疗保健专业人员、医疗保健组织代表和政策制定者。
分析57篇研究文章、10篇综述、1本书和8份其他文件后，在七个关键护理领域得出150个潜在质量指标。对这些指标进行质量评估后，得到58个概念质量指标，并提交给医疗保健专业人员专家小组。经过两轮德尔菲调查，发现30个质量指标（六个结构指标、17个过程指标和七个结果指标）适合用于监测和改善出院后产后护理质量。
这些质量指标形成了弗拉芒定性产后护理模式，卫生当局将其作为缩短住院时间背景下的最低标准实施。产后护理应根据灵活的住院时间进行调整，并在孕期开始制定个性化护理计划，该计划应贯穿母亲和新生儿的整个孕期、分娩期及产后阶段。出院标准以及关于护理组织和内容的地方协议对于促进护理连续性至关重要。
