Ryan Theo, McGrinder Tess, Smith Valerie
Pharmacy and Pharmaceutical Sciences, The University of Dublin Trinity College, Dublin, Leinster, D02, Ireland.
Albert Einstein College of Medicine, Montefiore Health System, New York, New York, NY10461, USA.
HRB Open Res. 2024 Jun 24;7:40. doi: 10.12688/hrbopenres.13905.1. eCollection 2024.
Care bundles, introduced in 2001, are described as a set of at least three evidence-based healthcare interventions delivered together in a clinical care episode by all healthcare providers. Although widely implemented in some healthcare areas, care bundle use in maternity care appears relatively recent. To identify the types of care bundles that have been developed, evaluated, or implemented for women during the perinatal period, we undertook a scoping review.
Joanna Briggs Institute methodological guidance for scoping reviews was used. MEDLINE, CINAHL, Embase, Maternity and Infant Care, and Epistemonikos were searched from January 2000 to October 2023. Records that reported on women during pregnancy and up to six-weeks postpartum as the intended or actual recipients of a care bundle, were included. The concept of interest was development, evaluation, or implementation of a care bundle. The context was maternity care provision, in any setting or geographical location.
The search yielded 147 eligible records of which 69 originated in the USA. Most records were concerned with care bundle evaluation (n=74), and most were published in the last five-years (n=95). Eleven categories of clinical conditions were identified. These were surgical site infection, obstetric haemorrhage, perineal trauma, sepsis, stillbirth, hypertension, safe reduction of caesarean section, enhanced recovery after caesarean, placenta accrete, perinatal anxiety/depression, and 'other' which contained 21 records reporting on care bundles for one clinical condition. Few clinical conditions had good overlap of care bundle elements. Systematic reviews based on data from non-randomised studies may be feasible for some clinical conditions.
This scoping review provides comprehensive insight on care bundles in maternity care. Few studies were found that evaluated the effectiveness of these bundles, and many bundles for similar clinical conditions contained diverse elements. A more global approach to care bundle development, evaluation, and implementation in maternity care is recommended.
护理包于2001年引入，被描述为一组至少三项基于证据的医疗保健干预措施，由所有医疗保健提供者在临床护理过程中共同实施。尽管在一些医疗保健领域广泛实施，但护理包在产科护理中的应用似乎相对较新。为了确定在围产期为女性开发、评估或实施的护理包类型，我们进行了一项范围综述。
采用乔安娜·布里格斯研究所范围综述的方法学指南。检索了2000年1月至2023年10月期间的MEDLINE、CINAHL、Embase、《母婴护理》和Epistemonikos数据库。纳入了报告孕期及产后六周内女性作为护理包预期或实际接受者的记录。感兴趣的概念是护理包的开发、评估或实施。背景是任何环境或地理位置下的产科护理提供情况。
检索产生了147条合格记录，其中69条来自美国。大多数记录涉及护理包评估（n = 74），且大多数是在过去五年发表的（n = 95）。确定了11类临床情况。这些是手术部位感染、产科出血、会阴创伤、败血症、死产、高血压、安全降低剖宫产率、剖宫产术后加速康复、胎盘植入、围产期焦虑/抑郁，以及“其他”，其中包含21条关于一种临床情况护理包的记录。很少有临床情况的护理包要素有很好的重叠。基于非随机研究数据的系统评价对某些临床情况可能是可行的。
这项范围综述提供了关于产科护理中护理包的全面见解。发现很少有研究评估这些护理包的有效性，并且许多针对类似临床情况的护理包包含不同的要素。建议在产科护理中采用更全面的方法来开发、评估和实施护理包。
