Mayes M E, Wilkinson C, Kuah S, Matthews G, Turnbull D
School of Psychology, University of Adelaide, Room 721a, Hughes Building, North Tce, Adelaide, SA, 5005, Australia.
BMC Health Serv Res. 2018 Feb 17;18(1):119. doi: 10.1186/s12913-018-2920-5.
The present study examines the introduction of an innovation in intrapartum foetal monitoring practice in Australia. ST-Analysis (STan) is a technology that adds information to conventional fetal monitoring (cardiotocography) during labour, with the aim of reducing unnecessary obstetric intervention. Adoption of this technology has been controversial amongst obstetricians and midwives, particularly as its use necessitates a more invasive means of monitoring (a scalp clip), compared to external monitoring from cardiotocography alone. If adoption of this technology is going to be successful, then understanding staff opinions about the implementation of STan in an Australian setting is an important issue for maternity care providers and policy makers.
Using a maximum variation purposive sampling method, 18 interviews were conducted with 10 midwives and 8 doctors from the Women's and Children's Hospital, South Australia to explore views about the introduction of the new technology. The data were analysed using Framework Analysis.
Midwives and doctors indicated four important areas of consideration when introducing STan: 1) philosophy of care; 2) the implementation process including training and education; 3) the existence of research evidence; and 4) attitudes towards the new technology. Views were expressed about the management of change process, the fit of the new technology within the current models of care, the need for ongoing training and the importance of having local evidence.
These findings, coupled with the general literature about introducing innovation and change, can be used by other centres looking to introduce STan technology.
本研究考察了澳大利亚产时胎儿监测实践中一项创新技术的引入情况。ST分析（STan）是一种在分娩过程中为传统胎儿监测（胎心宫缩图）增添信息的技术，旨在减少不必要的产科干预。这项技术的采用在产科医生和助产士中存在争议，特别是因为与仅通过胎心宫缩图进行外部监测相比，其使用需要一种侵入性更强的监测手段（头皮夹）。如果要成功采用这项技术，那么了解澳大利亚环境下工作人员对STan实施的看法，对于产科护理提供者和政策制定者来说是一个重要问题。
采用最大差异目的抽样法，对南澳大利亚妇女儿童医院的10名助产士和8名医生进行了18次访谈，以探讨对引入这项新技术的看法。使用框架分析法对数据进行分析。
助产士和医生指出，引入STan时需要考虑四个重要方面：1）护理理念；2）实施过程，包括培训和教育；3）研究证据的存在情况；4）对新技术的态度。对于变革过程的管理、新技术在当前护理模式中的适用性、持续培训的必要性以及获取本地证据的重要性，都表达了相关观点。
这些发现，再结合关于引入创新和变革的一般文献，可供其他希望引入STan技术的中心参考。
