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为即将早产的孕妇开发并快速推出 QUiPP 应用工具包。

Development and rapid rollout of The QUiPP App Toolkit for women who arrive in threatened preterm labour.

机构信息

Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK

Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK.

出版信息

BMJ Open Qual. 2021 May;10(2). doi: 10.1136/bmjoq-2020-001272.

Abstract

BACKGROUND

Often the first opportunity for clinicians to assess risk of preterm birth is when women present with threatened preterm labour symptoms (such as period-like pain, tightening's or back ache). However, threatened preterm labour symptoms are not a strong predictor of imminent birth. Clinicians are then faced with a complex clinical dilemma, the need to ameliorate the consequences of preterm birth requires consideration with the side-effects and costs. The QUiPP app is a validated app which can aid clinicians when they triage a women who is in threatened preterm labour.

AIM

Our aim was to produce a toolkit to promote a best practice pathway for women who arrive in threatened preterm labour.

METHODS

We worked with two hospitals in South London. This included the aid of a toolkit midwife at each hospital. We also undertook stakeholder focus groups and worked with two Maternity Voice Partnership groups to ensure a diverse range of voices was heard in the toolkit development. While we aimed to produce the toolkit in September 2020, we rapidly rolled out and produced the first version of the toolkit in April 2020 due to COVID-19. As the QUiPP app can reduce admissions and hospital transfers, there was a need to enable all hospitals in England to have access to the toolkit as soon as possible.

RESULTS

While the rapid rollout of The QUiPP App Toolkit due to COVID-19 was not planned, it has demonstrated that toolkits to improve clinical practice can be produced promptly. Through actively welcoming continued feedback meant the initial version of the toolkit could be continually and iteratively refined. The toolkit has been recommended nationally, with National Health Service England recommending the app and toolkit in their COVID-19 update to the Saving Babies Lives Care Bundle and in the British Association of Perinatal Medicine Antenatal Optimisation Toolkit.

摘要

背景

临床医生评估早产风险的首要机会通常是在女性出现早产威胁症状(如经期样疼痛、紧缩感或背痛)时。然而,早产威胁症状并不能很好地预测即将分娩。临床医生面临着一个复杂的临床困境,需要缓解早产的后果,同时需要考虑其副作用和成本。QUiPP 应用程序是一个经过验证的应用程序,可以帮助临床医生在对处于早产威胁中的女性进行分诊时使用。

目的

我们的目的是制作一个工具包,以促进对出现早产威胁的女性的最佳实践路径。

方法

我们在伦敦南部的两家医院开展工作。这包括每家医院都有一名工具包助产士的帮助。我们还进行了利益相关者焦点小组的讨论,并与两个产妇声音合作团体合作,以确保在工具包开发中听到各种不同的声音。虽然我们的目标是在 2020 年 9 月制作该工具包,但由于 COVID-19,我们在 2020 年 4 月迅速推出并制作了该工具包的第一个版本。由于 QUiPP 应用程序可以减少住院和医院转院,因此需要尽快使英格兰的所有医院都能获得该工具包。

结果

尽管由于 COVID-19 而迅速推出 QUiPP 应用程序工具包并非计划之内,但它表明可以迅速制作出改进临床实践的工具包。通过积极欢迎持续的反馈,意味着可以不断地对初始版本的工具包进行改进和完善。该工具包已在全国范围内得到推荐,英格兰国民保健署在其 COVID-19 更新中向 Saving Babies Lives 护理包和英国围产期医学协会产前优化工具包推荐了该应用程序和工具包。

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