基于“HCH”三级联动机制的孕产妇延伸护理模式的构建与实施

Construction and Implementation of Extended Nursing Model for Pregnant Women Based on"HCH"Three-level Linkage Mechanism

目的:研究“HCH”三级联动机制的孕产妇延伸护理模式的构建与实施。方法:制定孕产妇延伸护理模式实施路径(以综合医院为主导、社区医院为依托,家庭护理为重点场所的“医院-社区-家庭”三级联动的实施路径,基于“互联网+”平台孕产妇线上预约,一对一上门护理为延续护理的主要模式);制定产妇延续护理培训方案(包括产妇及新生儿基本生理特点、产妇及新生儿的居家自我管理、乳房护理和母乳喂养指导、产妇心理特征及其护理、子宫复旧情况、乳房情况、大小便情况、会阴伤口愈合情况、恶露、泌乳情况及盆底肌功能恢复情况);由医院、社区医务人员组建联动延伸护理团队,完成孕产妇医院护理、社区护理、居家护理的需求。建立产妇护理结局评价体系(产妇产后恢复相关指标、母乳喂养情况),评估产妇状态。结果:2022年2月—2023年5月延伸上门居家护理437人次,得到了孕产妇及家属的高度认可,无不良事件及投诉事件发生。结论:基于“HCH”三级联动机制的孕产妇延伸护理服务模式能提高对孕产妇的护理效率,为临床提供理论和实践指导。

Objective:To study the construction and implementation of extended nursing mode of"HCH"three-level linkage mechanism.Methods:The implementation path of the extended nursing model for pregnant and pregnant women was developed(the implementation path of the three-level linkage of"hospital-community-family",which was led by general hospitals,supported by community hospitals,and the key place of family nursing,was based on the online reservation of pregnant women on the"Internet+"platform,and one-to-one home nursing is the main mode of continued nursing).The training programmes for maternal extended nursing were developed(including basic physiological characteristics of mothers and newborns,self-management of mothers and newborns at home,breast care and breastfeeding guidance,maternal psychological characteristics and nursing,uterine rehabilitation,breast conditions,bowel and urine conditions,perineal wound healing,lochia,lactation and pelvic floor muscle function recovery).A collaborative and extended nursing team was formed by hospital and community medical personnel to meet the needs of hospital nursing,community nursing,and home nursing for pregnant and postpartum women.Maternal care outcome evaluation system was established(related indicators of postpartum recovery and breastfeeding)to assess the status of puerpera.Results:From February 2022 to May 2023,home nursing was extended to 437 people,which was highly recognized by pregnant women and their families,and no adverse events or complaints occurred.Conclusion:The extended nursing service model based on the"HCH"three-level linkage mechanism can improve the efficiency of nursing for pregnant women and provide theoretical and practical guidance for clinical practice.