广西妇幼保健院新生儿病房分级建设现状和能力建设需求

Classification construction and capacity building demand of neonatal wards of maternal and child health hospitals in Guangxi

目的调查广西妇幼保健院新生儿病房分级建设的现状和能力建设需求。方法采用《西部地区新生儿病房能力建设现况调查问卷》对广西14个地级市的39家(8家三级甲等、3家三级乙等、26家二级甲等、2家二级乙等)妇幼保健院新生儿病房分级建设情况和能力建设需求现状进行调查。结果 (1)新生儿病房基本建设:妇幼保健院新生儿病房床位数、新生儿重症监护病房床位数分别达到Ⅲ级a等、Ⅱ级a等要求,三甲妇幼保健院的辐射台、温箱配置基本达到要求;三级甲等、三级乙等、二级甲等、二级乙等妇幼保健院新生儿病房床位使用率分别为103. 35%、85. 00%、85. 00%、95. 00%。(2)人力资源配置:三级妇幼保健院的医生与床位比均未达标,医师硕士及以上学位构成比偏低(8. 18%),中、高级职称医生分别占39. 62%、20. 13%;二级妇幼保健院新生儿病房医师硕士学位构成比极低(1. 90%),中、高级职称医生分别占31. 90%、9. 82%。三级甲等、二级甲等、二级乙等妇幼保健院护士与床位比基本达标,三级乙等妇幼保健院未达标。二级、三级妇幼保健院中、高级职称护士分别占13. 96%、13. 85%。(3)急救仪器设备配置:各家妇幼保健院的抢救车、负压吸引装置、吸氧装置、心电监护仪、微量泵、输液泵、呼吸机、持续正压通气设备的配置基本完善,但T-组合复苏器、除颤仪配置率较低。(4)业务开展:各家妇幼保健院的高流量吸氧、出院后随访、新生儿转运的开展率较高,但外周动静脉同步换血治疗、经外周静脉置入静脉导管、脐动静脉置管整体业务开展水平较低。(5)教学:各家妇幼保健院开展了临床见习、临床实习、进修,三级妇幼保健院还开展了规范化培训。(6)能力建设需求:对增加培训机会、开展新业务新技术、培养专科护士的需求较高。结论广西妇幼保健院新生儿病房建设已经取得一定成绩,但仍存在不同差距,需加强新生儿病房分级建设和规范管理。

Objective To investigate the current situation of classification construction and capacity building demand of neonatal wards of maternal and child health hospitals(MCHHS)in Guangxi.Methods The questionnaire Survey on the Capacity Building of Neonatal Wards in Western Regions was used to investigate the current situation of the classification construction and capacity building demand of neonatal wards in 39 MCHHS(8,3rdgrade class A;3,3rdgrade class B;26,2ndgrade class A;2,2ndgrade class B)in 14 prefecture-level cities of Guangxi.Results(1)In term of basic construction of neonatal wards:the number of beds in neonatal wards of MCHHS and the number of beds in NICU met the requirements of gradeⅢa and gradeⅡa,respectively;the allocation of radiation table and temperature box in 3rdgrade class A MCHHS basically met the requirements;the utilization rates of beds in neonatal wards of the MCHHS of 3rdgrade class A,3rdgrade class B,2ndgrade class A,2ndgrade class B were 103.35%,85.00%,85.00%and 95.00%,respectively.(2)In term of the allocation of human resources:the ratio of doctors to beds was not up to the standard,the proportion of doctors with master’s degree or above was low(8.18%),doctors with middle and senior professional titles accounted for 39.62%and 20.13%,respectively in third grade MCHHS,and the data were 1.90%,31.90%,and9.82%correspondingly in 2ndgrade MCHHS;the ratio of nurses to beds in 3rdgrade class A,2ndgrade class A,and 2nd grade class B MCHHS basically met the standard,while 3rdgrade class B MCHHS did not meet the standard;and nurses with middle and senior professional titles in 2ndgrade and 3rdgrade MCHHS accounted for 13.96%and 13.85%,respectively.(3)In term of the allocation of first aid equipment:the allocation of ambulance,negative pressure suction device,oxygen inhalation device,ECG monitor,micro pump,infusion pump,respirator and continuous positive pressure ventilation equipment in MCHHS were basically perfect,but the allocation rate of T-combined resuscitator and defibrillator was low.(4)In term of business development:the development rates of the high flow oxygen inhalation,follow-up after discharge,and neonatal transport in MCHHS were high,but the overall business development levels of peripheral arteriovenous synchronous exchange therapy,peripheral venous catheterization,umbilical arteriovenous catheterization were low.(5)In term of teaching:all MCHHS had carried out clinical probation,clinical practice and further education,and 3rdgrade MCHHS had also carried out standardized training.(6)In term of the demand for capacity building:the demands for increasing training opportunities,developing new business and new technology,and training specialist nurses were quite high.Conclusion The construction of neonatal wards of MCHHS in Guangxi has made some achievements,but still there exist different gaps.Therefore,it is necessary to strengthen the classification construction and standardized management of neonatal wards.