University of La Rioja, Logroño (La Rioja) and Spanish Centre for Evidence-Based Nursing and Healthcare: A Joanna Briggs Institute Centre of Excellence, Madrid.
Health Service of La Rioja, Logroño, Spain.
JBI Evid Implement. 2021 Jul 1;19(3):245-256. doi: 10.1097/XEB.0000000000000288.
Pelvic floor muscle training (PFMT) enhances muscle strength and coordination, and prevents urinary incontinence associated with giving birth. The goal was to improve women's PFMT during pregnancy and postpartum in La Rioja, Spain.
This evidence implementation project used the JBI evidence implementation framework. First, we conducted the PFMT baseline audit: to assess the criteria for midwife training, we sent a questionnaire to all midwives. To measure the criteria for PFMT and urinary incontinence risk assessment, we reviewed the medical records of 60 women selected through consecutive sampling and 15 other women at risk of urinary tract infections (UTIs) for the inclusion criteria in a PFMT program. Second, we used the Getting Research into Practice guidelines to identify barriers to the fulfillment of each criterion and design and implement strategies to improve compliance. Finally, we repeated the audit to measure compliance and verify the changes.
The midwives received updated PFMT, optimizing compliance with the first criterion from 67 to 100%. The remaining criteria -- providing PFMT for pregnant women, identifying women at high risk of incontinence, and facilitating a supervised PFMT program for women at high risk of UTIs -- went from 0% compliance to 17, 96, and 67%, respectively.
This project was effective in building consensus, improving midwives' practice, and facilitating mothers' PFMT. The project continued during the novel coronavirus [coronavirus disease 2019 (COVID-19)] epidemic in Spain as the midwives, women, and managers were involved in the change because of a well designed registration system and the use of online tools for communication between midwives and women.
盆底肌肉训练（PFMT）可增强肌肉力量和协调性，并预防与分娩相关的尿失禁。目的是在西班牙拉里奥哈改善女性在怀孕和产后的 PFMT。
本证据实施项目使用了 JBI 证据实施框架。首先，我们进行了 PFMT 基线审核：为了评估助产士培训的标准，我们向所有助产士发送了一份问卷。为了衡量 PFMT 和尿失禁风险评估的标准，我们通过连续抽样选择了 60 名符合纳入 PFMT 计划标准的女性的医疗记录，并对另外 15 名有尿路感染（UTI）风险的女性进行了回顾性分析。其次，我们使用获取研究实践指南来确定每个标准实现的障碍，并设计和实施提高合规性的策略。最后，我们重复了审核，以衡量合规性并验证变化。
助产士接受了更新的 PFMT 培训，使第一项标准的合规性从 67%提高到 100%。其余标准——为孕妇提供 PFMT、识别尿失禁高风险女性以及为高危尿路感染女性提供监督 PFMT 计划——从 0%合规性提高到 17%、96%和 67%。
该项目在建立共识、改善助产士实践和促进母亲 PFMT 方面是有效的。该项目在西班牙新型冠状病毒（COVID-19）大流行期间继续进行，因为助产士、女性和管理人员参与了变革，这得益于设计良好的登记系统和助产士与女性之间使用在线工具进行沟通。
