Anaesthesia Department, National Maternity Hospital, Holles Street, Dublin 2, Ireland.
Anaesthesia Department, Coombe Women and Infants University Hospital, Cork Street, Dublin 8, Ireland.
Ir J Med Sci. 2023 Jun;192(3):1335-1338. doi: 10.1007/s11845-022-03098-4. Epub 2022 Jul 13.
This study involves two stand-alone tertiary level maternity hospitals with a combined average of 17,000 births per year, and with approximately 300 obstetric high dependency unit (OHDU) admissions annually. Many midwives feel that working in an OHDU does not constitute normal midwifery work and they have voiced concerns regarding their training in this setting. Midwives and nurses from different departments throughout the two hospitals are often asked to care for the OHDU patients. Co-location and expansion of a new OHDU, as well as a discussion around staffing, prompted this questionnaire.
The aim of this study was to formally assess midwives' and nurses' attitudes and confidence working in an OHDU.
After obtaining ethics committee approval, we conducted a survey and collected information on previous training in critical care, level of competence with HDU-related equipment and management of common HDU conditions.
In total, 188 staff participated in the survey (38% response rate). The majority (n = 142, 76%) did not feel competent caring for critically ill patients despite almost 40% (n = 69) saying they had experience doing so. Nurses or dual trained midwives were more likely to state they felt competent caring for critically ill patients, with only 2 midwives feeling competent (2.2%) compared to 32 nurses or dual trained staff (34.4%), p < 0.01. One hundred forty-seven (78%) and 136 (72%) respondents felt confident managing major haemorrhage and sepsis respectively. One hundred sixty-nine (89%) respondents would be interested in further training.
A greater proportion of nurses and dual trained midwives feel confident caring for ODHU patients. This survey suggests that a mixture of specialty-trained critical care nurses and midwives is required in order to provide a full complement of HDU care to both the antenatal and postnatal women.
本研究涉及两家独立的三级妇产医院，每年平均分娩量为 17000 例，每年约有 300 例产科高度依赖病房（OHDU）入院。许多助产士认为在 OHDU 工作不属于正常的助产工作，他们对在这种环境下的培训表示担忧。来自两家医院不同部门的助产士和护士经常被要求照顾 OHDU 患者。OHDU 的重新定位和扩张，以及人员配备的讨论，促使了这份问卷的产生。
本研究旨在正式评估助产士和护士在 OHDU 工作中的态度和信心。
在获得伦理委员会批准后，我们进行了一项调查，收集了有关重症监护培训、对 HDU 相关设备的熟练程度以及常见 HDU 疾病管理方面的信息。
共有 188 名员工参与了调查（38%的回应率）。尽管近 40%（n=69）的人表示有过这样的经验，但大多数（n=142，76%）人认为自己没有能力照顾重症患者。护士或双重培训的助产士更有可能表示他们有能力照顾重症患者，只有 2 名助产士（2.2%）感到有能力，而护士或双重培训的员工有 32 名（34.4%），p<0.01。147（78%）和 136（72%）名受访者分别对管理大出血和脓毒症有信心。169（89%）名受访者有兴趣进一步接受培训。
更多的护士和双重培训的助产士对照顾 OHDU 患者有信心。这项调查表明，需要配备一定数量的专科重症监护护士和助产士，才能为产前和产后妇女提供全面的 HDU 护理。
