上海市助产人员上岗培训需求调查

目的:了解助产人员知识技能现状及培训需求,为优化助产培训模式提供参考。方法:对上海市55家接产医院182名接受上岗培训的助产人员采用自行设计的问卷进行调查。结果:①助产人员对产科急症识别与处理的正确率最低(68.68%),羊水栓塞的临床表现掌握欠佳(70.33%),判断胎儿监护异常的正确率为72.32%。②助产人员中84.10%为大、中专学历,61.00%为护理专业转岗。③助产人员培训需求为延长培训时间,增设人性化助产技术服务的内容。④助产人员对产程中高风险因素识别和处理技能培训需要加强。结论:为提高产科质量,急需加强助产队伍建设,规范助产人员培训。     

学生标准化病人在助产专业实习前技能培训中的应用效果

目的探讨学生标准化病人在助产专业实习前技能培训中的应用效果。方法选取该院即将实习的2017级三年制助产专业两个班级学生98名,其中1班50名学生为试验组,2班48名学生为对照组。试验组应用学生标准化病人(SSP)模式培训,对照组应用该院常规实习前综合技能培训。结果技能培训结束后分析两组学生培训之后的实训成绩(病例分析、护理问诊、操作技能、健康教育)及两组学生满意度问卷调查。试验组学生培训后实训成绩及学生对培训方式的满意度均高于对照组,差异有统计学意义(t=6.416,χ2=4.680,P<0.05)。结论学生标准化病人应用于助产专业实习前技能培训中,能够有效提高助产专业学生的实训成绩,教学效果显著,学生对该教学方式普遍比较满意。     

临床肩难产产妇的助产护理效果

目的对临床肩难产产妇的助产护理效果进行分析探讨。方法将本院2015年1月—2017年12月收治的82例肩难产产妇随机分为两组,对照组41例患者行常规护理,观察组41例产妇在常规护理的基础上加强助产护理,对比两组产妇的妊娠结局及护理效果。结果观察组产后出血量明显少于对照组,P<0.05,差异有统计学意义。观察组自然分娩率为明显高于对照组,不良事件发生率明显低于对照组,P<0.05,差异有统计学意义。观察组护理满意度为95.12%,明显高于对照组的80.49%,P<0.05,差异有统计学意义。结论对肩难产产妇实施助产护理,能够提高分娩的安全性,有效改善妊娠结局,降低产妇及新生儿不良事件发生率。     

上海市长期护理保险居家护理人力培训体系现状分析

人力培训体系对长期护理保险(长护险)的居家护理人力供给起着至关重要的作用。通过文献分析、专家咨询、关键知情人访谈和数据二次分析等定性定量方法,对上海市长护险居家护理人力培训现状进行了剖析,并发现了上海市长护险居家护理人力培训体系中管理各自为政、培训体系与能力水平及支付制度联动缺乏和专业培训院校缺位的问题。提出了重构上海市长护险居家护理人力培训体系及呼吁职校高校设立相关专业,培训高素质人才的建议,以期使上海市长期护理保险居家护理人力培训体系蓬勃发展。     

产时保健新模式--责任制助产的可行性研究

目的：为了改进产科服务模式，提高产时保健服务质量，我们于1999－2000年在中山市妇幼保健院和深圳市妇儿医院进行了产时保健新模式－－责任制助产的可行性研究。方法：采用同期对照和历史对照研究的方法，将产妇分为责任制助产组和传统助产组。比较两组同期和不同历史时期的第一、第二产程时间，异常产程情况，产科并发症，阴道手术产、产伤发生情况，新生儿窒息率，工作时间效率，产妇满意度，结果：以上指标责任制组成优于传统组，结论：责任制助产既可以提高产科服务质量，又可以提高工作效率，加强医院定量管理，是一种可行的服务模式。     

Prevalence of needle stick injuries among dental, nursing and midwifery students in Shiraz, Iran

Background: The risk of occupational exposure to blood borne pathogens (including hepatitis B, hepatitis C and HIV) via sharp injuries such as needle stick injuries (NSIs) among health care workers, especially dental, nursing and midwifery students is a challenging issue. Inadequate staff, lack of experience, insufficient training, duty overload and fatigue may lead to occupational sharp injuries. The aim of this prospective cross-sectional study was to evaluate the frequency of NSIs in Iranian dental, nursing, and midwifery students and their knowledge, attitude and practices regarding prevention of NSIs.Methods: A questionnaire was provided to 264 dental and 435 nursing and midwifery students during their under graduate clinical training. 52% of dental students and 48% of nursing and midwifery students responded to the questionnaire. The questionnaire was pre-tested for reliability on 9.2% of the 55 sample population and found to have a high (r=0.812) test-retest reliability.Results: 73% of students reported at least one NSI during the past year. Activities most frequently associated with injuries involved use of a hollow-bore needle during venous sampling or IV injection in both groups, followed by wound suturing in nursing and midwifery students and recapping in dental students. NSIs and non-reporting of NSIs were highly prevalent in these participants. The reason for not reporting injuries included not knowing the reporting mechanism or not knowing to whom to report.Conclusion: Education about transmission of blood borne infections, standard precaution and increasing availability of protective strategies must be enforced. Furthermore, an optimization of the management for reporting is warranted.     

11个省市1004名护理管理者岗前培训需求调查

目的调查我国护理管理者岗前培训需求。方法采用自制的护理管理人员岗前培训调查表和未来5年护理管理人员管理技能问卷，对全国11个省市77家医院1004名护理管理者进行问卷调查。结果被调查对象中有45．8％的护理部主任和54．2％的护士长上岗前未参加岗前培训；有94．5％的被调查者认为护理管理者上岗前进行培训十分必要。讨论护理管理应进行岗前培训，其培训应分层次、有重点、按需求并逐渐形成制度化、规范化和系统化。     

The role of the World Health Organization in health related aspects of family planning

The World Health Organization works in health related aspects of human reproduction, family planning, and population dynamics with an emphasis on the integration of family planning services with basic health services and the strengthening of those services. It is also involved in research, training, health and medical education, and promotion of nursing, midwifery and health auxiliaries. WHO is the central agency responsible for the coordination of internal assistance to family planning programs and it aids in there evaluation.     

Midwifery factors associated with successful breastfeeding

Background It is well recognized that breast milk is the best form of nutrition for babies. However, many women do not breastfeed or give up soon after birth. Some report feeling unsupported in the post‐natal period and many stop breastfeeding earlier than they would have wished. This study aimed to estimate the separate effects of midwifery factors in the overall context of sociodemographic and clinical influences on breastfeeding. Methods Data from a national survey conducted in England in 2006 were used. Questionnaires were sent to a random sample of 4800 new mothers (63% response rate). Questions relating to infant feeding allowed calculation of rates of initiation of breastfeeding and rates of exclusive and any breastfeeding in the first few days and at 3 months. Univariate analyses were carried out to estimate the associations between sociodemographic, clinical and midwifery factors and breastfeeding. Logistic regression was used to estimate the specific effects of midwifery factors, while adjusting for other significant variables. Results The most powerful explanatory factor was antenatal feeding intention. Maternal age, absence of clinical problems in the baby and a short post‐natal stay were important in the early days. At 3 months, breastfeeding was associated with sociodemographic and intrapartum factors. At all stages, breastfeeding was significantly associated with either receiving consistent advice, practical help and/or active support and encouragement from midwives. Conclusions The antenatal decision about infant feeding is the most powerful predictor of infant feeding behaviour. Some sociodemographic and clinical factors are also important influences on breastfeeding. However, after adjusting for these, midwifery factors are still influential.