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加拿大的新生儿稳定护理:高危新生儿急性护理(ACoRN)实践与规划的更新

Neonatal stabilization in Canada: Updates to acute care of at-risk newborns (ACoRN) practices and programming.

作者信息

Aylward Deborah, Coughlin Kevin

机构信息

Canadian Paediatric Society, ACoRN Steering Committee, Ottawa, Ontario, Canada.

出版信息

Paediatr Child Health. 2022 Jun 13;27(3):190-191. doi: 10.1093/pch/pxac029. eCollection 2022 Jun.

Abstract

Disparities in preterm birth and neonatal mortality rates persist in Canada, in part as the result of insufficient training in newborn resuscitation and stabilization care, and inconsistent adherence to best practices. The Neonatal Resuscitation Program (NRP) has been the standard of care in all facilities providing perinatal care in Canada since the 1990s, but perinatal care providers and educators have continued to recognize gaps in knowledge and skill when stabilizing newborns post-resuscitation, especially in settings where this care is encountered infrequently. The Acute Care of at-Risk Newborns (ACoRN) program was developed to bridge such gaps. In ACoRN, an initial Primary Survey and systems-based care pathways (Sequences) prioritize and guide the assessment, essential care, and management of at-risk or unwell newborns in the first hours and days of life. This practice point highlights changes to practice and recommendations since 2012, when the ACoRN text and program were last revised. Like NRP, ACoRN is administered in Canada by the Canadian Paediatric Society (CPS). A newly revised and updated textbook and teaching program, both launched in 2021, will standardize care, increase competence and confidence among perinatal care providers, and improve neonatal outcomes in Canada and elsewhere in years to come.

摘要

加拿大早产和新生儿死亡率的差异依然存在,部分原因是新生儿复苏和稳定护理方面的培训不足,以及对最佳实践的遵循不一致。自20世纪90年代以来,新生儿复苏计划(NRP)一直是加拿大所有提供围产期护理机构的护理标准,但围产期护理提供者和教育工作者在复苏后稳定新生儿时,仍认识到知识和技能方面的差距,尤其是在很少遇到此类护理的环境中。高危新生儿急性护理(ACoRN)计划的制定就是为了弥补这些差距。在ACoRN中,初始的初级评估和基于系统的护理路径(序列)对出生后最初数小时和数天内高危或不适新生儿的评估、基本护理和管理进行优先排序并提供指导。本实践要点强调了自2012年ACoRN文本和计划上次修订以来的实践变化和建议。与NRP一样,ACoRN在加拿大由加拿大儿科学会(CPS)管理。2021年推出的一本新修订和更新的教科书及教学计划将规范护理,增强围产期护理提供者的能力和信心,并在未来几年改善加拿大及其他地区的新生儿结局。

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