Colet Paolo, Aimagambetova Gulzhanat, Kossybayeva Kapiza
School of Medicine, Nazarbayev University.
University Medical Center, National Research Center for Maternal and Child Health, Nur-Sultan, Kazakhstan.
JBI Evid Implement. 2020 Sep;18(3):318-326. doi: 10.1097/XEB.0000000000000234.
The current project generally aims to assess compliance with evidence-based criteria regarding postnatal care among women in a national hospital in Kazakhstan.
Improvements in reducing maternal and infant mortality in Kazakhstan have been noted over the past 2 decades. However, recent studies have indicated that care given to women during the perinatal period, which includes the postnatal period, is unsatisfactory. In addition, service delivery remains unstandardized, while outdated and inconsistent application of practice guidelines are observed in the clinical setting.
Following the JBI Practical Application of Clinical Evidence System and Getting Research into Practice audit and feedback tool with three phases of activities, this project utilizes an implementation framework that incorporates quality improvement. Also, the audit tool consists of seven criteria to assess compliance with evidence-based postnatal care.
Results indicate varying levels of compliance with the seven criteria used in this project. Criteria 1 and 7, which document postnatal plan and psychological assessment, garner the highest compliance at 100% in baseline and follow-up data collection. The compliance rate on criterion 4, which discusses the prevention of sudden infant death syndrome, decreases from 64% on the baseline to 29% on the follow-up. Similarly, criterion 6, which provides information about bottle feeding, exhibits further decrease with compliance from 43 to 40%. Importantly, increased compliance was noted on criterion 5, which is about breastfeeding, from 58 to 95% from the baseline and follow-up audit.
The current study successfully implements evidence-based inpatient postnatal care in Kazakhstan and reveals varying results on compliance and the increasing knowledge of nurses and midwives on evidence-based postnatal care.
当前项目总体目标是评估哈萨克斯坦一家国立医院中女性产后护理符合循证标准的情况。
过去20年里，哈萨克斯坦在降低母婴死亡率方面取得了进步。然而，近期研究表明，围产期（包括产后）为女性提供的护理并不理想。此外，服务提供仍未标准化，临床实践中存在过时且不一致的实践指南应用情况。
本项目遵循JBI临床证据系统的实际应用以及“将研究转化为实践”审核与反馈工具，开展三个阶段的活动，采用了一个包含质量改进的实施框架。此外，审核工具由七条标准组成，用于评估产后循证护理的符合情况。
结果显示，本项目所采用的七条标准的符合程度各不相同。标准1和标准7，即记录产后计划和心理评估，在基线和随访数据收集时的符合率最高，均为100%。标准4讨论了预防婴儿猝死综合征，其符合率从基线时的64%降至随访时的29%。同样，标准6提供奶瓶喂养信息，其符合率从43%进一步降至40%。重要的是，标准5关于母乳喂养的符合率从基线审核时的58%升至随访审核时的95%。
当前研究在哈萨克斯坦成功实施了循证住院产后护理，并揭示了符合情况的不同结果，以及护士和助产士对循证产后护理知识的增加。
