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产房剖宫产:助产士、麻醉医生和产科医生观点之探究

Cesarean Section in the Delivery Room: An Exploration of the Viewpoint of Midwives, Anaesthesiologists, and Obstetricians.

作者信息

Jolien Jansegers, Yves Jacquemyn

机构信息

Antwerp University Hospital (UZA) and Antwerp University (UA) - ASTARC, Belgium.

出版信息

J Pregnancy. 2018 Sep 27;2018:1017572. doi: 10.1155/2018/1017572. eCollection 2018.

Abstract

AIM

To explore the attitude and vision of midwives, anaesthesiologists, and obstetricians concerning a dedicated operating room for cesarean sections within the delivery ward versus cesarean sections within the general operating room.

METHOD

A descriptive qualitative study using a constructive paradigm. Face-to-face semistructured interviews were performed in 3 different hospitals, one without operating theatre within the delivery ward, one with a recently built cesarean section room within the delivery ward, and one with a long time tradition of cesarean section in the delivery room. Interviews have been analysed thematically.

RESULTS

Three themes have been identified: organization, role of the midwife, and safety. Although identical protocols for the degree of emergency of a cesarean section are used, infrastructure and daily practice differ between hospitals. Logistic support, medical and midwife staffing, and hospital infrastructure are systematically mentioned as needing improvement. Realizing cesarean section within the delivery ward was considered as an improvement for the patient's experience. Midwives need a clear and new job description and delineation and mention a lack of formal education to assist surgical procedures. To increase patient safety continuous education and communication are considered necessary.

CONCLUSION

A detailed job description and education of all those involved in cesarean section at the delivery ward are necessary to improve patient safety. Patient experience is improved, but our knowledge on this is hampered by lack of studies.

摘要

目的

探讨助产士、麻醉师和产科医生对于产房内专门的剖宫产手术室与普通手术室进行剖宫产手术的态度和看法。

方法

采用建构主义范式进行描述性定性研究。在3家不同的医院进行面对面的半结构化访谈,一家产房内没有手术室,一家产房内有最近新建的剖宫产手术室,一家产房内有长期进行剖宫产手术的传统。访谈采用主题分析法进行分析。

结果

确定了三个主题:组织、助产士的角色和安全。虽然剖宫产手术的紧急程度使用相同的方案,但不同医院的基础设施和日常实践有所不同。后勤支持、医疗和助产士人员配备以及医院基础设施被一致认为需要改进。在产房内进行剖宫产手术被认为可以改善患者体验。助产士需要清晰、全新的工作描述和职责界定,并提到缺乏协助手术程序的正规教育。为提高患者安全,持续教育和沟通被认为是必要的。

结论

为提高患者安全,有必要为产房内所有参与剖宫产手术的人员制定详细的工作描述并开展教育。患者体验得到了改善,但由于缺乏研究,我们对此的了解受到了阻碍。

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本文引用的文献

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Emergency obstetric care: Making the impossible possible through task shifting.紧急产科护理:通过任务转移让不可能成为可能。
Int J Gynaecol Obstet. 2015 Oct;131 Suppl 1:S6-9. doi: 10.1016/j.ijgo.2015.02.004. Epub 2015 Feb 24.
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Exploring the skin-to-skin contact experience during cesarean section.探索剖宫产术中的皮肤接触体验。
J Am Assoc Nurse Pract. 2016 Jan;28(1):31-8. doi: 10.1002/2327-6924.12229. Epub 2015 Mar 12.
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Enhancing midwives' scope of practice: an innovative educational program for delivery suite operating rooms.
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