Bjerga Birgitte G, Risa Mari, Blix Ellen, Pay Aase S Devold
Department of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway.
Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway.
Eur J Midwifery. 2019 Jul 25;3:14. doi: 10.18332/ejm/110064. eCollection 2019.
In 2010, the Norwegian Directorate of Health introduced the guideline 'Safe maternity services - quality standards for maternal care'. These standards include adequate staffing with health care personnel for birth units to ensure responsible monitoring and treatment. Birth units are to follow the professional recommendation that every woman has a midwife present during established labor. This study presents data from birth units on compliance with the national recommendation for one-to-one care during labor.
A web-based questionnaire was emailed to chief midwives of all birth units in Norway (n=48) in May 2018. The questionnaire contained a total of nine multiple-choice, scaled-response-format, and free-text questions.
The questionnaire response rate was 100%. All birth units reported that they offered women one-to-one care during labor to a large extent. Sixty-five per cent of the birth units had procedures to ensure that midwives were present during established labor. Deviations from the recommendation were recorded in one-fourth of birth units. Thirty-eight per cent of respondents reported that staff training had been provided; 56% of birth units stated that the recommendation led to an increased presence of midwives during labor. Financial constraints (35%) and difficulty of compliance (27%) were cited as obstacles to meeting the recommendation for one-to-one care during labor.
The majority of birth units reported that they follow the recommendation for one-to-one care during established labor, but compliance with this recommendation in practice remains unclear. Areas of improvement relate to routines describing the presence of midwives during labor, registration of deviations, and staff training in one-to-one care.
2010年，挪威卫生局出台了“安全孕产服务——孕产妇护理质量标准”指南。这些标准包括为分娩单位配备足够的医护人员，以确保进行负责的监测和治疗。分娩单位应遵循专业建议，即每位产妇在进入规律宫缩期时都要有一名助产士在场。本研究展示了分娩单位关于分娩期间一对一护理国家建议的遵守情况数据。
2018年5月，通过电子邮件向挪威所有分娩单位的首席助产士（n = 48）发送了一份基于网络的调查问卷。该问卷共有九个多项选择题、量表式回答题和自由文本问题。
问卷回复率为100%。所有分娩单位均报告称，他们在很大程度上为产妇提供了分娩期间的一对一护理。65%的分娩单位有程序确保助产士在进入规律宫缩期时在场。四分之一的分娩单位记录了与建议的偏差。38%的受访者报告称提供了员工培训；56%的分娩单位表示该建议使分娩期间助产士的在场率有所提高。资金限制（35%）和难以遵守（27%）被列为分娩期间一对一护理建议实施的障碍。
大多数分娩单位报告称，他们遵循进入规律宫缩期时一对一护理的建议，但实际遵守该建议的情况仍不明确。需要改进的方面包括描述分娩期间助产士在场情况的常规流程、偏差记录以及一对一护理方面的员工培训。
