提高医疗服务质量 确保母婴安康

Increase the medical and service quality and to ensure the safety of mothers and infants

通过对医院传统产科管理模式的改革，建立了一种全新的产科责任制管理模式，即产前区实行“责任 工作制”，产房实行“全程专责陪伴分娩”制度，并与传统的产科管理模式进行产科质量的比较。结果产前区２０００年９ ～１２月，医护人员总计加班１７８人次，消灭医疗隐患，堵住医疗漏洞２８人次；２０００年产房责任制助产与１９９７年传统 产房助产模式医疗质量比较，产程时间平均下降 ３．２４ ｈ；异常阴道分娩：吸引产、产钳分别下降４７．５０％和 ６６．６９％；潜 伏期延长、活跃期停滞、第二产程延长、滞产下降了１００％，均为Ｐ＜０．０１。新生儿重度、轻度窒息下降了６１．１１％和 ５１．７０％，新生儿气管插管下降了８６．７０％，均为Ｐ<0．０１。宫颈裂伤下降６４．２３％，Ｐ＜０．０１；会阴Ⅲ度裂伤下降１００％。 产后大出血下降７６．６０％，会阴侧切伤口感染率下降８７．７８％，均为Ｐ＜０．０１。死产、孕产妇死亡率下降１００％，Ｐ＞０．０５。 产房剖宫产率二年间无显著差异Ｐ＞０．０５。提示产科实行责任制管理，大大提高了产科的医疗和服务质量，最大限度地 消灭了医疗隐患，说明这种新的产科管理和工作模式是先进的，可行的。

Objective: To increase the work quality in the Gynecology Department and to ensure the safety of mothers and infants by reforming the traditional administrative models. Methods: 'The System of Responsibility before Delivery' and 'Responsib1e Parturition Accompanied throughout the Whole Process'has been carried out and then the qualities were compared. Results: There was no significant difference between the two groups of cae- sarean operation (P >0. 05). From Sep. to Dec. in 2 000, the medical staff worked extra hours total1y 178 times to eliminate hidden risks, to have avoided 28 times of potentia1 medical loopholes. The new models de- creased the delivery time by 3. 24 hours and produced decreased 47. 50% in suction de1ivery, 66. 69% in forceps delivery.' 100% in prolonged incubation period, stasis of active period, prolonged birth process and protrated labor (P<0. 01). 61. 11% and 51. 70% respectively in severe and mild neonate suffocation (P<0. 01). 86. 70% in trachea1 incubation, 64. 23% in laceration of cervix , 100% in third degree laceration of perineum, 76. 60% in postpartum hemorrhage, 87. 78% in the infection rate of laceration of perineum (all above P<0. 01). And 100% in dead birth and maternal mortality (P<0. 05). Conclusion: The app1ication of the responsible ad- ministration has significantly increased the medical and service quality in the Gyneology Department, which shows that this new administrative model is advanced and practical.