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澳大利亚维多利亚州农村和地区产妇管理者和教育者对母婴急症(MANE)教育项目的看法:一项定性描述性研究。

Rural and regional maternity managers' and educators' views of the Maternity and Newborn Emergencies (MANE) education program in Victoria, Australia: a qualitative descriptive study.

机构信息

Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, 3086, Australia.

Royal Women's Hospital, Parkville, VIC, Australia.

出版信息

BMC Health Serv Res. 2024 Jan 3;24(1):8. doi: 10.1186/s12913-023-10466-y.

Abstract

BACKGROUND

Australia has one of the lowest perinatal morbidity and mortality rates in the world, however a cluster of perinatal deaths at a regional health service in the state of Victoria in 2015 led to state-wide reforms, including the introduction of the Maternity and Newborn Emergencies (MANE) program. MANE was a 2-day interprofessional maternity education program delivered by external expert facilitators to rural and regional Victorian maternity service providers. An independent evaluation found that the MANE program improved the confidence and knowledge of clinicians in managing obstetric emergencies and resulted in changes to clinical practice. While there is a large volume of evidence that supports the use of interprofessional education in improving clinicians' clinical practice, the impact of these programs on the overall safety culture of a health service has been less studied. Managers and educators have an important role in promoting the safety culture and clinical governance of the heath service. The aim of this study, therefore, was to explore Victorian rural and regional maternity managers' and educators' views and experiences of the MANE program.

METHODS

Maternity managers and educators from the 17 regional and rural health services across Victoria that received the MANE program during 2018 and 2019 were invited to participate. Semi-structured interviews using mostly open-ended questions (and with a small number of fixed response questions) were undertaken. Qualitative data were transcribed verbatim and analysed thematically. Descriptive statistics were used for quantitative data.

RESULTS

Twenty-one maternity managers and educators from the 17 health services participated in the interviews. Overall, participants viewed the MANE program positively. Four themes were identified: the value of external facilitation in providing obstetric emergency training; improved awareness and understanding of clinical governance; improved clinical practice; and the importance of maintaining the program. Participants agreed that MANE had improved the confidence (94%) and skills (94%) of clinicians in managing obstetric emergencies, as well as confidence to escalate concerns (94%), and most agreed that it had improved clinical practice (70%) and teamwork among attendees (82%).

CONCLUSION

Maternity managers and educators were positive about MANE; they considered that it contributed to improving factors that impact the safety culture of health services, with delivery by external experts considered to be particularly important. Given the crucial role of maternity managers and educators on safety culture in health services, as well in program facilitation, these findings are important for future planning of maternity education programs across the state.

TRIAL REGISTRATION

Trial registration was not required for this study.

摘要

背景

澳大利亚拥有世界上最低的围产期发病率和死亡率之一,然而,2015 年维多利亚州一个地区卫生服务中心发生的一系列围产期死亡事件导致了全州范围的改革,包括引入母婴急症(MANE)计划。MANE 是一项为期两天的跨专业产妇教育计划,由外部专家顾问向维多利亚州农村和地区的产妇服务提供者提供。一项独立评估发现,MANE 计划提高了临床医生处理产科急症的信心和知识,导致了临床实践的改变。虽然有大量证据支持使用跨专业教育来改善临床医生的临床实践,但这些计划对卫生服务整体安全文化的影响研究较少。管理者和教育者在促进卫生服务的安全文化和临床治理方面发挥着重要作用。因此,本研究旨在探讨维多利亚州农村和地区产妇管理者和教育者对 MANE 计划的看法和经验。

方法

邀请在 2018 年和 2019 年期间接受 MANE 计划的维多利亚州 17 个地区和农村卫生服务中心的产妇管理者和教育者参加。采用半结构化访谈,主要采用开放式问题(并辅以少量固定回答问题)。对定性数据进行逐字转录,并进行主题分析。定量数据采用描述性统计。

结果

来自 17 个卫生服务中心的 21 名产妇管理者和教育者参加了访谈。总体而言,参与者对 MANE 计划持积极态度。确定了四个主题:外部协助提供产科急症培训的价值;提高对临床治理的认识和理解;改善临床实践;以及维持该计划的重要性。参与者一致认为,MANE 提高了临床医生处理产科急症的信心(94%)和技能(94%),以及升级关注的信心(94%),大多数人还认为它改善了临床实践(70%)和与会者之间的团队合作(82%)。

结论

产妇管理者和教育者对 MANE 持积极态度;他们认为这有助于改善影响卫生服务安全文化的因素,外部专家的参与被认为尤为重要。鉴于产妇管理者和教育者在卫生服务安全文化以及计划实施中的重要作用,这些发现对该州未来的产妇教育计划规划具有重要意义。

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