正常分娩第二、三产程护理措施的最佳证据总结

Best evidence summary of nursing measures in the second and third stages of normal delivery

目的检索分析正常分娩第二、三产程的相关指南,并对高质量指南进行证据总结,为临床实践方案的制订提供参考。方法以Johns Hopkins循证护理实践模式为理论指导,组建循证团队,系统检索国内外主要的指南发布网站、电子资源数据库、相关的学术团体及指南网等,评价指南并汇总最佳证据,检索时限截至2019年6月1日,由4名经过循证培训的研究人员独立进行文献质量评价与证据提取。结果本研究共纳入2篇指南,总结出人文支持、分娩陪伴、分娩体位、胎儿监测、延迟用力、会阴保护、宫底加压、预防产后出血、延迟断脐9个方面20条最佳证据。结论基于现有证据整合了正常分娩第二、三产程护理措施的最佳证据,建议母婴机构结合自身实际情况促进最佳证据转化。

Objective To retrieve and analyze the relevant guidelines for the second and third stages of normal delivery,and summarize the evidence of high-quality guidelines so as to provide references for the formulation of clinical practice programs.Methods We took Johns Hopkins evidence-based nursing practice model as theoretical guidance and set up an evidence-based team.We systematically searched major guideline publication websites,electronic resource databases,related academic groups and guideline networks at home and abroad,evaluated guidelines and summarized the best evidence,and the search time limit was up to June 1,2019.The literature quality evaluation and evidence extraction were carried out independently by four researchers with evidence-based training.Results This study included two guidelines,summarizing the 20 best evidences in 9 aspects of humanistic support,delivery companion,delivery position,fetal monitoring,delayed exertion,perineal protection,fundus compression,prevention of postpartum hemorrhage,and delayed umbilical cord clamping.Conclusions Based on the existing evidence,it integrates the best evidence of nursing measures for the second and third stages of normal delivery.It is recommended that maternal and child institutions promote the transformation of the best evidence based on their actual conditions.