“常用避孕节育技术临床应用规范”在宁夏穆斯林农村地区的应用效果评估

Effective evaluation about clinical guidelines of contraceptive technique establishment and probation: an intervention study in rural areas of Ningxia Muslim Region

目的评价项目规范试用对宁夏穆斯林地区计划生育技术服务质量的影响和项目规范的可接受性。方法对宁夏穆斯林地区项目现场开展干预研究。根据基线评估结果,制定和试行项目规范,形成以建立相关的质量管理制度,加强技术人员业务培训,规范服务过程,完善服务记录等为主要内容的综合干预方案。运用定性、定量研究方法对干预效果进行评价。结果经过项目干预,机构服务环境改善,内部管理与外部监督机制初步建成;技术服务术前术后的咨询指导、服务记录、术前准备、消毒隔离与感染控制、无菌操作、术后观察与康复指导等服务过程得到了重视;技术人员的专业知识水平,服务能力及服务记录较前规范,专业知识测试总分由基线的平均39.03分增加到终末的平均79.30分,项目干预组服务记录填写评分高出对照组10分;项目规范的适用性得到了使用者的肯定,终末评估时群众对技术服务的满意度较基线时有所提高(71.5%vs.57.7%)。结论项目规范与综合干预可以有效提高计划生育技术服务能力和管理质量。

Objective To explore the executive process,technical influence and acceptability of the technical guidelines after the guidelines establishment and probation.Methods The study was intervention conducted in rural areas of Ningxia Muslim Region.The intervention included implementing and testing the established technical guidelines,using uniformed family planning service records,training administrative personnel and service providers,supervising and assessing.Baseline and final information was collected through qualitative and quantitative methods,including service procedure observation on the spot,in-depth interview with service providing staff,technical examination among technical practitioners,and structured questionnaire investigation among reproductive aged women.Results After the intervention,the service infrastructure were optimized.The internal and external administration and supervision mechanism were basically founded.Family planning service procedures were improved,particularly the provision of the greeting and counseling,the history enquiring,the preoperative laboratory test,operations procedures,and procedures of follow up.Service providers＇ relevant technical knowledge was advanced and the score of technical examination was raised from 39.03 to 79.30.The quality of medical records in application group was better than that of control group.The average score of the record accomplishment was by 10 score higher in the application group than that in control group.The appropriation and practicability of clinical guidelines were considered acceptable by the service staff.Clients＇ satisfaction was increased from 57.7% of baseline to 71.5% of final investigation.Conclusion The established technical guideline and its implementation can largely improve the quality of the family planning service and promote the capacity building of management.