新的科学管理方法在围产期保健工作中的应用及观察

Application and observation of new scientific management methods in perinatal health care

目的分析围产期保健管理现状以及存在问题,评价加强围产期保健管理效果,总结管理经验。方法2015年1月～2015年10月,在开展常规围产期管理过程中,建档464份,2015年12月,开始推行新的围产期保健管理制度,2016年1月～2016年10月,建档482份;新的强化围产期保健工作主要包括,加强管理,规范建立围产期保健档案、丰富档案内容,关注高危人群,对于SDS、SAS量表阳性者,选派心理干预护士进行心理干预,根据产前自护表、产后新生儿照料表、产后自护表,除落实常规宣教外,重点加强产妇缺失内容的宣教,给产妇提供更丰富的宣教服务,采用微信提供院外随访服务。结果2016年,优质分娩率、产妇满意率分别为88.0%、97.5%,高于2015年(79.7%、91.0%),产科并发症、计划外助产干预、新生儿疾病、产后并发症发生率分别为7.7%、14.7%、11.6%、2.3%,低于2015年(11.2%、22.6%、18.1%、5.6%),差异有统计学意义(P<0.05);2016年住院时间、顺产产妇产程、产后42日内返院次数低于2015年,差异有统计学意义(P<0.05)。结论新的围产期保健管理制度极大的提高了保健服务水平,使母儿获益。

Objective To evaluate the effect of perinatal health care management and summarize the management experience through analyzing the current situation and problems of perinatal health care management in the hospital.Methods The new perinatal health care management system which mainly strengthen perinatal health care work was implemented since December 2015.464 files were established using routine perinatal management process between January 2015 and October 2015 and 482 files between January 2016 and October 2016.Measures included to strengthen management,establish standardized perinatal health archives,enrich the contents of the file,and pay more attention to high -risk groups.Psychological intervention were conducted to those women who have positive scores screened by self-rating depression scale and self-rating anxiety scale.According to prenatal self-care scale,postpartum neonatal care scale,postpartum self-care scale,specific focus was paid on strengthening the missing part for pregnant women in addition to the implementation of general education,more health education were provided and WeChat service was used for follow up service.Results High quality delivery rate was 88.0 ％ and maternal satisfaction rate was 79.7％ respectively in 2016 which was higher than 2015 （97.5％ and 91.0 ％ respectively）,rate of obstetric complications,unplanned midwifery intervention,neonatal disease,postpartum complication was significantly lower in 2016 compared with those in 2015.It＇s 7.7％,14.7％,11.6％,2.3％ respectively in 2016 while it＇s 11.2％,22.6％,18.1％,and 5.6％ in 2015.the difference was statistically significant （P ＜ 0.05）.Total hospitalization days,natural labor period,frequency of back to the hospital within postpartum 42 days were significantly reduced in 2016 than 2015 （P ＜ 0.05）.Conclusion Mothers and children benefited from the new perinatal health care management system which greatly improved quality of health care services.