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国家孕产妇安全合作伙伴关系:阿片类药物使用障碍女性产科护理共识包。

National Partnership for Maternal Safety: Consensus Bundle on Obstetric Care for Women With Opioid Use Disorder.

机构信息

Department of Obstetrics, Gynecology & Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, Pennsylvania; the Center for Substance Abuse Treatment at the Substance Abuse Mental Health Services Administration, Washington, DC; UT Health San Antonio School of Nursing, San Antonio, Texas; the Department of Obstetrics and Gynecology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Premier Inc., Charlotte, North Carolina; the National Association of Nurse Practitioners in Women's Health, Washington, DC; Massachusetts General Hospital, Boston, Massachusetts; the California Maternal Quality Care Collaborative, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California; the National Organization on Fetal Alcohol Syndrome (NOFAS), Washington, DC; the Department of Family & Community Medicine, Center for Bioethics, Urban Health & Policy, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania; the Central Jersey Family Health Consortium, North Brunswick, New Jersey; the American College of Obstetricians and Gynecologists, Washington, DC; and the Department of Obstetrics and Gynecology and Psychiatry, Virginia Commonwealth University, Richmond, Virginia.

出版信息

Obstet Gynecol. 2019 Aug;134(2):365-375. doi: 10.1097/AOG.0000000000003381.

Abstract

The opioid epidemic is a public health crisis, and pregnancy-associated morbidity and mortality due to substance use highlights the need to prioritize substance use as a major patient safety issue. To assist health care providers with this process and mitigate the effect of substance use on maternal and fetal safety, the National Partnership for Maternal Safety within the Council on Patient Safety in Women's Health Care has created a patient safety bundle to reduce adverse maternal and neonatal health outcomes associated with substance use. The Consensus Bundle on Obstetric Care for Women with Opioid Use Disorder provides a series of evidence-based recommendations to standardize and improve the quality of health care services for pregnant and postpartum women with opioid use disorder, which should be implemented in every maternity care setting. A series of implementation resources have been created to help providers, hospitals, and health systems translate guidelines into clinical practice, and multiple state-level Perinatal Quality Collaboratives are developing quality improvement initiatives to facilitate the bundle-adoption process. Structure, process, and outcome metrics have also been developed to monitor the adoption of evidence-based practices and ensure consistency in clinical care.

摘要

阿片类药物流行是一个公共卫生危机,与物质使用相关的与妊娠相关的发病率和死亡率突出表明需要将物质使用作为主要的患者安全问题优先考虑。为了帮助医疗保健提供者完成这一过程,并减轻物质使用对产妇和胎儿安全的影响,妇女健康护理患者安全理事会中的国家产妇安全合作伙伴关系创建了一个患者安全捆绑包,以减少与物质使用相关的不良产妇和新生儿健康结局。《阿片类药物使用障碍产妇产科护理共识捆绑包》提供了一系列基于证据的建议,以标准化和提高患有阿片类药物使用障碍的孕妇和产后妇女的医疗保健服务质量,该捆绑包应在每个产妇保健环境中实施。创建了一系列实施资源,以帮助提供者、医院和医疗系统将指南转化为临床实践,并且多个州级围产期质量合作组织正在制定质量改进计划,以促进捆绑包的采用过程。还制定了结构、过程和结果指标,以监测基于证据的实践的采用情况,并确保临床护理的一致性。

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