临床护理路径在自然分娩中的应用和效果评价

目的探索临床护理路径在自然分娩中的应用及效果。方法方便性抽样选择上海交通大学附属第六人民医院产科2010年1-6月自然临产的孕妇453例为对照组,2010年7-12月自然临产的孕妇478例为观察组。对照组实施常规分娩护理,观察组应用临床护理路径进行分娩护理。评估两组间产程中阴道检查次数、各产程时间、产后出血量、产后出血发生率、产程中剖宫产术情况、住院费用、患者出院后满意率等指标的差异,对临床护理路径进行效果评价。结果观察组第一产程时间明显短于对照组、阴道检查次数明显少于对照组(均P<0.05),因产程异常行手术者例数低于对照组(P<0.05),而因胎儿宫内窘迫、社会因素行手术所占比例两组间差异无统计学意义(P>0.05)。两组患者分娩过程满意率比较,观察组明显高于对照组(P<0.01)。两组患者住院费用比较,观察组明显低于对照组(P<0.05)。结论临床护理路径的实施从整体着眼,避免了不必要的护理操作,规范了产程的观察和处理,有助于降低产程异常所致的剖宫产率以及患者住院费用,提高了产妇和家属对护理工作满意率。

Application and Effect Evaluation of Clinical Nursing Pathway in Virginal Delivery

Objective To explore the application of clinical nursing pathway in virginal delivery and to evaluate the effect. Methods According to use clinical nursing pathway in virginal delivery or not, the patients were divided into experimental group（n=478,July-December 2010） and control group（n= 453, January-June 2010）. During virginal delivery,the frequencies of virginal examination, the labor time, the incidence and volume of postpartum hemorrhage, the caesarean rate during labor, and hospitalization cost and satisfaction were compared to evaluate the effect of clinical nursing pathway in virginal delivery. Results The time of the first stage in the experimental group was shorter than that of the control group （P〈 0.05）. The frequeney of virginal examination in experimental group was less than that in the control group （P〈0.05）. The caesarean section cases of abnormal labor were significantly different between experimental group and control group （P〈0.05）. The surgeries due to fetal distress and social factors occupied a similar proportion （P〉0.05）. Compared with the control group, the delivering satisfactions among patients were significantly higher in the experimental group （P〈0.01）. The hospitalization cost of the experimental group was significantly lower than that of the control group（P〈0.05）. Conclusion As a whole,clinical nursing pathway can avoid unnecessary nursing manipulation, standardize the treatment of labor process, decrease the caesarean section rate, and improve the satisfaction of parturient to clinical service.