助产机构正常产程分娩照护循证实践方案构建

Development of An Evidence-Based Practice Protocol for Normal Labor and Childbirth Care in Maternity Settings

目的 构建基于最佳证据的助产机构正常产程分娩照护实践方案。方法 通过典型助产机构内关键知情人访谈,梳理正常产程管理及分娩照护过程的焦点问题,系统检索文献,提取证据,构建正常产程分娩照护循证实践方案草案,通过专家论证确定证据的推荐等级,形成最终方案及标准化实施路径。结果 助产机构正常产程分娩照护循证实践方案包括分娩照护准则、第一产程照护、第二产程照护、第三产程照护、新生儿照护及妇女产后早期照护共6个方面的90条证据推荐意见。结论 正常产程分娩照护循证实践方案的构建过程科学严谨,有助于规范国内助产士的正常产程管理及分娩照护实践行为,为后续阶段本方案的临床实施及评价提供指导依据。

Objective To develop an best-evidence-based practice protocol for normal labor and childbirth care in maternity settings.Methods The draft of evidence-based practice protocol for normal labor and childbirth care was developed by interviewing with key informants from typical maternity settings,identifying key issues in the process of normal labor management and childbirth care,systematically reviewing literature and extracting evidence.The expert consultation was conducted to identify the recommendation grades of the evidence.The final protocol and standard operating procedures were then formulated.Results The evidence-based practice protocol for normal labor and childbirth care in maternity settings contained 6 aspects,including childbirth care principles,the first-stage labor care,the second-stage labor care,the third-stage labor care,newborn care and early postpartum care for women,with a total of 90 pieces of recommendations.Conclusions The development of evidence-based practice protocol for normal labor and childbirth care is scientific and rigorous.It can help to standardize midwives’practice of normal labor management and childbirth care in China,so as to provide guidance for subsequent clinical implementation and evaluation of this protocol.