Abdalla Elsheikh Nihal Eltayeb, M Osman Hanady Me, Alfaki Ahmed Sahar Altayeb, Elsamani Mohamed Shahinaz Abdelgaium, Alhessen Saidahmed Ryan Osman, Awad Eltalkhawy Rewan Samy Said, Ahmed Elbashir Hadeel Mohammed
Obstetrics and Gynecology, Najran Armed Forces Hospital, Ministry of Defense Health Services, Najran, SAU.
Quality and Patient Safety, Najran Armed Forces Hospital, Ministry of Defense Health Services, Najran, SAU.
Cureus. 2025 Aug 1;17(8):e89215. doi: 10.7759/cureus.89215. eCollection 2025 Aug.
Obstetric triage systems play a vital role in ensuring timely care for pregnant women, yet their implementation and effectiveness vary across healthcare settings. This systematic review synthesizes evidence on the impact of standardized obstetric triage systems on care timeliness, staff competency, and maternal-fetal outcomes, while examining barriers and facilitators to successful implementation in diverse contexts. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic search across six databases (PubMed, Embase, Scopus, Web of Science, CINAHL, IEEE Xplore). Eligible studies evaluated obstetric triage interventions, reported quantitative or mixed-methods data on implementation/effectiveness outcomes (e.g., time to assessment, length of stay (LOS), staff knowledge), and were peer-reviewed. 11 studies met inclusion criteria and were evaluated using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool for risk of bias; seven were rated as low risk. Due to heterogeneity in interventions, outcomes, and settings (high- vs low-resource), a narrative synthesis was performed. Key findings demonstrated that standardized triage tools significantly reduced the time from patient arrival to initial evaluation by a healthcare provider (time to provider assessment) and LOS in high-resource settings. In low-resource contexts, locally adapted models reduced median waiting times from 40 minutes to five minutes, though systemic barriers like understaffing persisted. Successful implementation relied on staff training and workflow integration, while variability in adoption reflected organizational culture. Limitations included heterogeneity precluding meta-analysis and under-representation of low-resource settings. Obstetric triage standardization enhances care efficiency, but effectiveness depends on contextual adaptation and multidisciplinary engagement. Future research should prioritize randomized controlled trials (RCTs), cost-effectiveness analyses, and tailored strategies for low-resource settings.
产科分诊系统在确保为孕妇提供及时护理方面发挥着至关重要的作用，但其实施情况和效果在不同的医疗环境中存在差异。本系统评价综合了关于标准化产科分诊系统对护理及时性、工作人员能力以及母婴结局影响的证据，同时考察了在不同背景下成功实施的障碍和促进因素。按照系统评价和Meta分析的首选报告项目（PRISMA）指南，我们在六个数据库（PubMed、Embase、Scopus、Web of Science、CINAHL、IEEE Xplore）中进行了系统检索。符合条件的研究评估了产科分诊干预措施，报告了关于实施/效果结局（如评估时间、住院时间（LOS）、工作人员知识）的定量或混合方法数据，并且经过同行评审。11项研究符合纳入标准，并使用干预性非随机研究的偏倚风险（ROBINS-I）工具进行偏倚风险评估；其中7项被评为低风险。由于干预措施、结局和环境（高资源与低资源）存在异质性，因此进行了叙述性综合分析。主要研究结果表明，在高资源环境中，标准化分诊工具显著缩短了患者到达至医护人员进行初始评估的时间（至医护人员评估的时间）以及住院时间。在低资源环境中，因地制宜的模式将中位等待时间从40分钟缩短至5分钟，不过人员配备不足等系统性障碍依然存在。成功实施依赖于工作人员培训和工作流程整合，而采用情况的差异反映了组织文化。局限性包括异质性妨碍了Meta分析以及低资源环境的代表性不足。产科分诊标准化提高了护理效率，但其效果取决于因地制宜的调整和多学科参与。未来的研究应优先开展随机对照试验（RCT）、成本效益分析以及针对低资源环境的定制策略。
