产时持续质量改进管理策略对产妇分娩的影响

Effect of the management strategy of intrapartum continuous quality improvement on delivery

目的：探讨产时持续质量改进管理策略对产妇分娩的影响。方法：将2012年1月~2014年11月于我院分娩的产妇作为研究对象,实施持续质量改进策略,包括分娩知识宣教时间前移;建立产妇自然分娩的信心,提倡自然分娩,减少干预;分娩评估及告知;改善分娩支持措施;提高助产技术;分娩质量评价指标的目标监测等。监测产妇自然分娩率、会阴侧切率、导乐分娩率及母婴创伤发生率的变化。结果：实施产时持续质量改进管理策略后,产妇自然分娩率、会阴侧切率由2012年50.2%、38.0%变化为2014年56.6%、15.9%,两者比较差异有统计学意义（P〈0.05）;母婴创伤发生率变化差异无统计学意义（P〈0.05）。结论：产时持续质量改进管理策略能有效提高产妇自然分娩率,降低会阴侧切率。

To investigate the effect of the management strategy of intrapartum continuous quality improvement on delivery. Methods ： The puerperant who had childbirth in our hospital from January 2012 to November 2014 were taken as the object of study and the management strategy of intrapartum continuous quality improvement was implemented,including early health education on delivery, establishment Of the confidence in natural childbirth, reducing the intervention, evaluation on delivery quality and monitoring on indexes and the changes of nat- ural delivery rate, episiotomy rate, Doula delivery rate and the incidence of maternal and infant trauma. Results ：After the implementation of the management strategy of intrapartum continuous quality improvement, the natural childbirth rate and episiotomy rate changed from 50. 2% and 38.0% in 2012 to 56.6% and 15.9% in 2014 （ P 〈 0.05） ; the difference in the comparison of the incidence of maternal and infant trauma was not statistically significant. Conclusion：The management strategy of intrapartum continuous quality improvement can ef- fectively improve the natural delivery rate and reduce the episiotomy rate.