Davies B L, Niday P A, Nimrod C A, Drake E R, Sprague A E, Trépanier M J
School of Nursing, Faculty of Health Sciences, University of Ottawa, ON.
CMAJ. 1993 May 15;148(10):1737-42.
To determine the current status of electronic fetal monitoring (EFM) in Canadian teaching and nonteaching hospitals, to review the medical and nursing standards of practice for EFM and to determine the availability of EFM educational programs.
National survey in 1989.
The directors of nursing at the 737 hospitals providing obstetric care were sent a questionnaire and asked to have it completed by the most appropriate staff member. The response rate was 80.5% (593/737); 44 hospitals did not have deliveries in 1988 and were excluded. The remaining hospitals varied in size from 8 to 1800 (mean 162.1) beds and had 1 to 7500 (mean 617.1) births in 1988; 18.8% were teaching hospitals.
Of the 549 hospitals 419 (76.3%) reported having at least 1 monitor (range 1 to 30; mean 2.6); the mean number of monitors per hospital was higher in the teaching hospitals than in the nonteaching hospitals (6.2 v. 1.7). Manitoba had the lowest mean number of monitors per hospital (1.1) and Ontario the highest (3.7). In 71.8% of the hospitals with monitors almost all of the obstetric patients were monitored at some point during labour. However, 21.6% of the hospitals with monitors had no policy on EFM practice. The availability of EFM educational programs for physicians and nurses varied according to hospital size, type and region.
Most Canadian hospitals providing obstetric services have electronic fetal monitors and use them frequently. Although substantial research has questioned the benefits of EFM, further definitive research is required. In the meantime, a national committee should be established to develop multidisciplinary guidelines for intrapartum fetal assessment.
确定加拿大教学医院和非教学医院电子胎儿监护（EFM）的现状，回顾EFM的医学和护理实践标准，并确定EFM教育项目的可获得性。
1989年的全国性调查。
向提供产科护理的737家医院的护理主任发送问卷，并要求由最合适的工作人员填写。回复率为80.5%（593/737）；44家医院在1988年没有分娩，被排除在外。其余医院规模从8张床位到1800张床位不等（平均162.1张），1988年分娩数从1例到7500例不等（平均617.1例）；18.8%为教学医院。
在549家医院中，419家（76.3%）报告至少有1台监护仪（范围为1至30台；平均2.6台）；教学医院每家监护仪的平均数量高于非教学医院（6.2台对1.7台）。曼尼托巴省每家医院监护仪的平均数量最低（1.1台），安大略省最高（3.7台）。在71.8%拥有监护仪的医院中，几乎所有产科患者在分娩期间的某个时间点都接受了监护。然而，21.6%拥有监护仪的医院没有EFM实践政策。针对医生和护士的EFM教育项目的可获得性因医院规模、类型和地区而异。
大多数提供产科服务的加拿大医院拥有电子胎儿监护仪并经常使用。尽管大量研究对EFM 的益处提出了质疑，但仍需要进一步的确定性研究。与此同时，应成立一个全国性委员会，制定产时胎儿评估的多学科指南。
