Johansen Lars T, Pay Aase Serine Devold, Broen Lise, Roland Brit, Øian Pål
Tidsskr Nor Laegeforen. 2017 Sep 18;137(17). doi: 10.4045/tidsskr.16.1070. Print 2017 Sep 19.
The Directorate of Health’s national guide Et trygt fødetilbud – kvalitetskrav til fødselsomsorgen [A safe maternity service – requirements regarding the quality of maternity care] was published in December 2010 and was intended to provide a basis for an improved and more predictable maternity service. This article presents data from the maternity institutions on compliance with the quality requirements, including information on selection, fetal monitoring, organisation, staffing and competencies.
The information was acquired with the aid of an electronic questionnaire in the period January–May 2015. The form was sent by e-mail to the medical officer in charge at all maternity units in Norway as at 1 January 2015 (n=47).
There was a 100 % response to the questionnaire. The criteria for selecting where pregnant women should give birth were stated to be in conformity with the quality requirements. Some maternity institutions failed to describe the areas of responsibilities of doctors and midwives (38.5 % and 15.4 %, respectively). Few institutions recorded whether the midwife was present with the patient during the active phase. Half of the maternity departments (level 2 birth units) reported unfilled doctors’ posts, and a third of the university hospitals/central hospitals (level 1 birth units) reported a severe shortage of locum midwives. Half of the level 2 birth units believed that the quality requirements had resulted in improved training, but reported only a limited degree of interdisciplinary or mandatory instruction.
The study reveals that there are several areas in which the health enterprises have procedures that conform to national quality requirements, but where it is still unclear whether they are observed in practice. Areas for improvement relate to routines describing areas of responsibility, availability of personnel resources and staff training.
卫生局的国家指南《安全的产科服务——产科护理质量要求》于2010年12月发布，旨在为改善和更可预测的产科服务提供基础。本文展示了产科机构在质量要求合规方面的数据，包括关于选择、胎儿监测、组织、人员配备和能力的信息。
2015年1月至5月期间，借助电子问卷获取信息。该表格通过电子邮件发送给截至2015年1月1日挪威所有产科单位的主管医务人员（n = 47）。
问卷回复率为100%。据指出，选择孕妇分娩地点的标准符合质量要求。一些产科机构未能描述医生和助产士的职责范围（分别为38.5%和15.4%）。很少有机构记录助产士在活跃期是否陪伴患者。一半的产科部门（二级分娩单位）报告有医生职位空缺，三分之一的大学医院/中心医院（一级分娩单位）报告临时代理助产士严重短缺。一半的二级分娩单位认为质量要求带来了更好的培训，但报告称跨学科或强制性指导程度有限。
该研究表明，在一些领域，卫生企业有符合国家质量要求的程序，但在实际中是否得到遵守仍不明确。需要改进的方面涉及描述职责范围的常规、人员资源的可用性和员工培训。
