产房护理质量敏感指标的构建及应用

Construction and application of sensitive indicators of nursing quality in delivery room

目的:构建产房护理质量敏感指标并应用于产房护理质量管理中。方法:采用德尔菲法确定产房护理质量敏感指标并将其应用于产房正常分娩的孕妇,收集每月监测数据进行动态分析,针对分析结果实施针对性的护理措施。结果:构建了15项产房护理质量敏感指标。2轮专家权威系数分别为0.86、0.89,协调系数分别为0.47、0.55(均P<0.05),护理质量敏感指标应用组的产妇满意度、正常分娩率、会阴完整率、早期皮肤接触/早吸吮率及硬膜外分娩镇痛实施率均高于传统护理管理组(P<0.05),阴道试产中转剖宫产率、产后出血率低于传统护理管理组(P<0.05),新生儿窒息率及护理不良事件发生率中侧切伤口感染率、新生儿产伤发生率与传统护理管理组比较差异无统计学意义(P>0.05)。结论:产房护理质量敏感指标的构建并应用于产房护理质量管理中,提高了产房的护理质量和产妇对护理工作的满意度。

Objective:To explore the construction and application of sensitive indicators of nursing quality in delivery room.Methods:Searching the domestic and foreign literatures on obstetric sensitive indicators,and Delphi method was used to determine the sensitive indicators of nursing quality which were applied to parturient women in delivery room,collected monthly monitoring data for dynamic analysis.The nursing satisfaction,incidence of nursing adverse events,spontaneous delivery rate,conversion rate of vaginal trial delivery to cesarean section,implementation rate of epidural labor analgesia,neonatal asphyxia rate,perineum integrity rate,postpartum hemorrhage rate,early skin contact rate/early sucking rate were observed and compared between the application group and the traditional nursing management group.Results:15 sensitive indicators of nursing quality in delivery room were constructed.The authority coefficient of two rounds of expert were 0.86 and 0.89,and the coordination coefficients were 0.47 and 0.55 respectively(P<0.05).The maternal satisfaction,spontaneous delivery rate,perineum integrity rate,early skin contact/early sucking rate and epidural labor analgesia implementation rate in application group were higher than the other group(P<0.05),the rate of conversion to cesarean section and postpartum hemorrhage were lower(P<0.05),but there were no significant differences in neonatal asphyxia rate and the incidence of adverse nursing events between the two groups(P>0.05).Conclusion:The application of sensitive indicators in delivery room can improve the quality of nursing care and maternal satisfaction.