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培训卫生工作者预防和处理产后出血(PPH)。

Training health workers to prevent and manage post-partum haemorrhage (PPH).

机构信息

Elizabeth Garrett Anderson Wing, University College Hospital, 25 Grafton Way, London, WC1E 6DB, UK.

Women & Children's Department, Gloucestershire Royal Hospital, Great Western Road, Gloucester, GL1 3NN, UK.

出版信息

Best Pract Res Clin Obstet Gynaecol. 2019 Nov;61:121-129. doi: 10.1016/j.bpobgyn.2019.05.008. Epub 2019 May 20.

Abstract

Post-partum haemorrhage (PPH) is the second greatest direct cause of maternal death in the United Kingdom, and rates of PPH continue to increase despite advances in clinical care. Training workers to manage PPH involves improvement of technical and non-technical skills in the context of a multidisciplinary team (MDT). Management of PPH should begin in the antenatal period, with identification of high-risk women and referral for multispecialty input. Training for the acute management of PPH should involve all members of the labour ward team and beyond, including haematology and non-clinical staff. Simulation-based training, didactic teaching and hybrid obstetric emergency courses are current options for training workers. Non-technical skills should also be taught, including specific training on communication, leadership, situational awareness and team-working skills. Improving management of obstetric emergencies requires thorough antenatal and intra-partum risk assessment, optimising knowledge and non-technical skills of individual members of the team, improving collaboration of the MDT, better simulation training and adjusting local infrastructure.

摘要

产后出血(PPH)是英国产妇死亡的第二大直接原因,尽管临床护理有所进步,但 PPH 的发生率仍在上升。培训工作人员管理 PPH 涉及在多学科团队(MDT)的背景下提高技术和非技术技能。PPH 的管理应在产前阶段开始,识别高危妇女并转介多专业人员。PPH 的急性管理培训应包括产房团队成员以及血液科和非临床人员。基于模拟的培训、理论教学和混合产科急症课程是目前培训工作人员的选择。还应教授非技术技能,包括沟通、领导力、情境意识和团队合作技能的专项培训。改善产科急症的管理需要进行全面的产前和产时风险评估,优化团队成员的知识和非技术技能,改善 MDT 的协作,更好的模拟培训和调整当地基础设施。

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