产科护理敏感质量指标在持续质量改进中的应用
Application of obstetric nursing-sensitive quality indicators in continuous quality improvement.
作者信息
Luo Liu, Wang Longqiong, Zhang Min, Liao Bizhen
机构信息
The First Clinical College of Chongqing Medical University Chongqing City, China.
Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University Chongqing City, China.
出版信息
Am J Transl Res. 2022 Jan 15;14(1):643-655. eCollection 2022.
OBJECTIVE
To verify the effect of obstetric nursing-sensitive quality indicators for continuously improving nursing quality.
METHODS
We retrospectively analyzed the obstetric nurse quality in the First Affiliated Hospital of Chongqing Medical University and University-Town Hospital of Chongqing Medical University from October 2019 to September 2020. Nurses and patients in the Obstetrics Department of the First Affiliated Hospital of Chongqing Medical University and University-Town Hospital of Chongqing Medical University were respectively assigned into an experimental group and a control group. High-quality nursing services were provided to patients in both groups. In addition to the high-quality nursing services, the obstetric nurses in the experimental group received training on obstetric nursing-sensitive quality indicators based on the knowledge-attitude-practice model. An obstetric nursing quality evaluation was conducted between the two groups. Continuous quality improvement was achieved using the plan-do-check-act (PDCA) cycle. The nursing quality was reflected by 14 obstetric nursing-sensitive quality indicators and the nurses' job satisfaction was compared between the experimental group and the control group before and after intervention.
RESULTS
The information regarding the nurses and parturients, and the nurses' job satisfaction were not significantly different between the two groups before intervention (P>0.05). Except for information regarding the lateral perineotomy at vaginal delivery, there was no significant difference in other obstetric nursing-sensitive quality indicators between the two groups before the intervention. In the experimental group, the rates of early skin-to-skin contact between mothers and infants, early sucking with exclusive breastfeeding during hospitalization, parturient satisfaction with the nurses' work, and nurses' job satisfaction after intervention were better than before (P<0.05). In the experimental group, the rates of neonatal asphyxia/severe neonatal asphyxia and postpartum hemorrhage following vaginal delivery after intervention was significantly lower than before (P<0.05). The experimental group had better outcomes than the control group in the rates of early skin-to-skin contact between mothers and infants, early sucking with exclusive breastfeeding during hospitalization, parturient satisfaction with the nurses' work, and nurses' job satisfaction (P<0.05).
CONCLUSION
Obstetric nursing-sensitive quality indicators can be used to improve the nursing quality in continuous quality improvement, which is worthy of promotion in clinics.
目的
验证产科护理敏感质量指标对持续提高护理质量的效果。
方法
回顾性分析重庆医科大学附属第一医院和重庆医科大学大学城医院2019年10月至2020年9月的产科护理质量。重庆医科大学附属第一医院和重庆医科大学大学城医院产科的护士和患者分别被分为实验组和对照组。两组均为患者提供优质护理服务。除优质护理服务外，实验组的产科护士接受基于知-信-行模式的产科护理敏感质量指标培训。对两组进行产科护理质量评估。采用计划-执行-检查-处理（PDCA）循环实现持续质量改进。通过14项产科护理敏感质量指标反映护理质量，并比较实验组和对照组干预前后护士的工作满意度。
结果
干预前两组护士及产妇的信息及护士工作满意度差异无统计学意义（P>0.05）。干预前两组除阴道分娩会阴侧切相关信息外，其他产科护理敏感质量指标差异无统计学意义。实验组干预后母婴早期皮肤接触率、住院期间纯母乳喂养早期吸吮率、产妇对护士工作的满意度及护士工作满意度均优于干预前（P<0.05）。实验组干预后阴道分娩新生儿窒息/重度新生儿窒息及产后出血发生率明显低于干预前（P<0.05）。实验组在母婴早期皮肤接触率、住院期间纯母乳喂养早期吸吮率、产妇对护士工作的满意度及护士工作满意度方面的结果均优于对照组（P<0.05）。
结论
产科护理敏感质量指标可用于持续质量改进中提高护理质量，值得临床推广。
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