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妊娠期 B 族链球菌定植的筛查和管理指南的依从性。

Adherence to screening and management guidelines of maternal Group B Streptococcus colonization in pregnancy.

机构信息

King Edward Memorial Hospital, Perth, Western Australia, Australia.

Edith Cowan University, Perth, Western Australia, Australia.

出版信息

J Adv Nurs. 2022 Oct;78(10):3247-3260. doi: 10.1111/jan.15249. Epub 2022 Apr 15.

Abstract

AIMS

To investigate Group B Streptococcus (GBS) colonization in pregnancy; adherence to antenatal GBS screening and adherence to the intrapartum antibiotics protocol within two models of care (midwifery and non-midwifery led).

DESIGN

This retrospective quantitative study has employed a descriptive design using administrative health data.

METHODS

Data from five maternity hospitals in metropolitan and regional Western Australia that included 22,417 pregnant women who gave birth between 2015 and 2019 were examined, applying descriptive statistics using secondary data analysis.

RESULTS

The study revealed an overall GBS colonization rate of 21.7% with similar rates in the different cohorts. A lower adherence to screening was found in the midwifery led model of care (MMC, 68.76%, n = 7232) when compared with the non-midwifery led model of care (NMMC, 90.49%, n = 10,767). Over the 5 years, screening rates trended down in the MMC with stable numbers in the counterpart. Adherence in relation to intrapartum antibiotic prophylaxis revealed discrepant findings between the study groups.

CONCLUSION

Adherence to screening and management guidelines of maternal GBS colonization in pregnancy is lower within the MMC when compared with the NMMC.

IMPACT

This is the first cohort study to describe the adherence to the recommended Western Australian GBS screening guidelines in the two different models of care. Findings may assist in the guidance and improvement of clinical protocols as well as the planning of clinical care in relation to GBS screening to reduce the risk of neonatal GBS infection.

摘要

目的

研究妊娠期间 B 群链球菌(GBS)定植情况;在两种护理模式(助产士主导和非助产士主导)中,依从产前 GBS 筛查和依从产时抗生素方案的情况。

设计

本回顾性定量研究采用描述性设计,使用了行政健康数据。

方法

对 2015 年至 2019 年间在西澳大利亚州大都市和地区的 5 家妇产医院分娩的 22417 名孕妇进行了数据分析,采用二次数据分析进行了描述性统计。

结果

研究显示,总体 GBS 定植率为 21.7%,不同队列中的定植率相似。在助产士主导的护理模式(MMC)中,筛查的依从性较低(68.76%,n=7232),而非助产士主导的护理模式(NMMC)中,筛查的依从性较高(90.49%,n=10767)。在 5 年期间,MMC 中的筛查率呈下降趋势,而对照的数量则保持稳定。在产时抗生素预防方面的依从性,在研究组之间存在不一致的发现。

结论

与 NMMC 相比,在 MMC 中,妊娠期间 GBS 定植的筛查和管理指南的依从性较低。

影响

这是第一项描述在两种不同护理模式中,依从西澳大利亚 GBS 筛查指南的队列研究。研究结果可能有助于指导和改进临床方案,以及规划与 GBS 筛查相关的临床护理,以降低新生儿 GBS 感染的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/309e/9546437/63e4d21a8c51/JAN-78-3247-g007.jpg

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