探讨助产士门诊对流动人口孕妇妊娠结局的影响

目的探讨助产士门诊对流动人口孕妇妊娠结局的影响。方法回顾性分析2006年7月至2008年7月在我院分娩的流动人口孕产妇6236例,其中以2006年7月至2007年7月3076例（实施流动人口孕产妇管理前）作为对照组,以2007年7月至2008年7月3160例（实施流动人口孕产妇管理后）作为观察组,对比两组产前检查次数、住院分娩率、满意度以及不良妊娠结局。结果观察组产前检查覆盖率、住院分娩率、满意度明显高于对照组,差异有统计学意义（Hc=36395,P〈0.01）;观察组顺产者比对照组多,差异有统计学意义（χ2=126.44,P〈0.01）。观察组不良妊娠结局的发生率低于列照组,差异有统计学意义（P〈0.05）;两组产后出血及巨大儿发生率比较,差异无统计学意义（P〉0.05）。结论通过启用助产士门诊,加强流动人口孕产妇产前检查及随访,可以有效减少流动人口孕产妇不良妊娠结局的发生率。     

我国助产士专业体系构建的质性研究

目的：探讨我国助产士专业体系的构建,为我国制定助产士制度、规范助产士任职资格和岗位任务提供参考意见,推动我国助产学科向更规范化、更合理的方向发展。方法应用半结构访谈法对8个省市26家不同级别的综合医院妇产科、妇幼保健院、妇产医院的业务院长、产科主任、产科医生、助产士及产科护士41名专业人员,进行访谈,对助产士专业体系构建进行研究。结果经过深入访谈和分析,提炼出4个主题：目前从事助产工作的人员结构;助产士岗位任务现状;构建我国助产士专业体系重要性、必要性以及应包括哪些内容;助产士的岗位任务和任职资格应该包括哪些。结论我国应尽快发展助产士制度,加强助产士培训和教育,制定助产士准入制度及相应的助产士法律法规,规范助产士管理,明确助产士任职资格和岗位任务,制定规范的助产士晋升制度,实现助产专业科学管理,促进助产学科发展,从而促进母婴健康,保障母婴安全。     

Midwives’ lived experience of caring for new mothers with initial breastfeeding difficulties: A phenomenological study

ObjectiveThe aim of this study is to obtain a deeper understanding of midwives’ lived experiences of caring for new mothers with initial breastfeeding difficulties.MethodsA reflective lifeworld approach was used. Six midwives were recruited from a hospital in western Sweden. Data were collected via individual lifeworld interviews and analysed using phenomenological methods.ResultsThe essential meaning can be described as a midwife’s wish to help new mothers reach their breastfeeding goals by trying to interact with them as individual women in unique breastfeeding situations. This wish constitutes a contradiction to the midwife’s own desire to succeed in enabling mothers to breastfeed and the perceived risk of failure as a midwife if the mothers decide not to breastfeed. This is further described by five constituents: striving to provide individualised care, collegial and personal responsibility both enables and prevents care, a struggle to be sufficient, an uphill struggle and mutual joy becomes the motivation to care.ConclusionsCaring for new mothers with initial breastfeeding difficulties is a balancing act between the midwife’s personal desire to succeed in enabling mothers to breastfeed, the mothers’ wishes, the infants’ needs, the importance of collective collegial competence and the limitations in the health care organisation. This makes the midwife's efforts to provide individualised care frustrating and demanding as well as motivating.     

Routine interventions in childbirth before and after initiation of an Action Research project

BackgroundUnnecessary routine interventions in uncomplicated labour and birth, like cardiotocography (CTG), amniotomy, use of scalp electrode and oxytocin treatment, are associated with further interventions that could harm the woman and the infant. A four year Action Research (AR) project was done on a labour ward to enhance the capacity of local midwives in the promotion of physiological labour and birth.AimTo describe the use of interventions during labour and birth in healthy women at term with spontaneous onset of labour, before and after initiation of an Action Research project.MethodsA retrospective before and after comparative study of clinical records from 2009 (before) and 2012 (after), based on a random selection of records from primiparous and multiparous women. Outcome measures were duration of admission CTG, frequency of admission CTG over 30 min, frequency of amniotomy, use of scalp electrode, and frequency of oxytocin augmentation in spontaneous labour.Results903 records were included. The duration of admission CTG (p = 0.001), frequency of admission CTG duration over 30 min (p = <0.001), the use of scalp electrodes (p = <0.001), and use of oxytocin augmentation of spontaneous labour (p = 0.014) were reduced significantly after initiation of the AR project. There were no significant differences in frequency of amniotomy, duration of total CTG, postpartum bleeding, sphincter tears, Apgar score <5 at 5 min, and mode of birth.ConclusionFollowing an AR project, several interventions were reduced during labour and birth. Controlled studies in other settings are needed to assess the impact of collaborative action on decreasing unnecessary interventions.     

A workforce profile comparison of practising and non-practising midwives in Australia: baseline data from the Midwives and Nurses e-Cohort Study

Existing workforce data, as an estimate of the current capability of the midwifery workforce to provide midwifery care, is confounded by systematic reporting issues that may overestimate the potential of the existing midwifery workforce. This paper reports the characteristics of qualified Australian midwives who responded to the baseline data collection in the Midwives and Nurses e-Cohort Study and compares those who are currently practising in midwifery with those who are not. Currently practising midwives represented only 52% of those respondents who identified as midwives and the profile of the typical midwife is female, aged over 40 years, Australian, married or in a de facto relationship. She has been registered for over 10 years, educated to postgraduate diploma level and currently works in a clinical midwifery role in a hospital for less than 35 hours per week. Specific deficits in the Australian midwifery workforce namely low numbers of indigenous midwives, independent practitioners and midwives suitably qualified to teach and undertake research in academia are identified. Drawing on the nationally representative e-cohort data, this cross-sectional analysis identifies for the first time the real face of the Australian midwifery workforce and provides an evidence-based foundation for future workforce planning and a methodology for other countries interested in accurately monitoring their actual and potential midwifery workforce.     

江苏省107所医疗机构助产士门诊开展现状的调查研究

目的 了解江苏省医疗机构助产士门诊的开展现状,并分析影响其开展的因素,为今后助产士门诊的建设及相关服务政策的制订提供参考依据。 方法 2021年1月采用自行设计的江苏省医疗机构助产士门诊开展现状调查表,对江苏省13个城市,共116所二级及以上医疗机构的助产士门诊开展现状进行调查。 结果 最终,107所医疗机构完成调查,开展助产士门诊的医疗机构有48所（44.86%）,其中11所（22.92%）每周只开诊4 h。妇幼保健类专科医院开设助产士门诊的比例和每周开诊时间高于综合性医院,三级医院开设助产士门诊的比例高于二级医院（P<0.05）;三级医院、妇幼保健类专科医院的出诊者学历较高（P<0.05）;妇幼保健类专科医院开始介入管理的孕周较早、开展模拟分娩较多（P<0.05）。所有已开设助产士门诊的医疗机构都没有专门配套的电子病历系统。影响59所医疗机构未开设助产士门诊的前3个原因是：没有医院政策支持、人员不足、不知道如何开展。 结论 助产士门诊在江苏省医疗机构中普及率不足50%,应加大综合性医院、二级医院助产士门诊的普及率;增加已开设助产士门诊医疗机构的门诊开诊时间、提高开诊质量,加快建设助产士门诊电子病历系统。建议在人力资源、出诊时间、软件信息、质量控制等政策上提供进一步支持和监督。     

助产士一对一全程陪伴联合配偶产程支持干预在单胎足月初产妇经阴道分娩过程中的应用效果分析

目的 探讨助产士一对一全程陪伴联合配偶产程支持干预在单胎足月初产妇经阴道分娩过程中的应用效果.方法 选取单胎足月初产妇183例,均经阴道分娩,根据护理干预方法的不同分为对照组(n=88)和观察组(n=95).对照组接受常规分娩护理干预,观察组在对照组基础上接受助产士一对一全程陪伴联合配偶产程支持干预,比较两组干预前后的...     

助产士职业感染的预防

医务人员因工作性质、工作环境的特殊性，常常暴露各种现存的或潜在的危险因素中，助产士更是在这种特殊环境中从事护理专业的群体。她们经常暴露于被产妇血液、体液、羊水污染以及锐器损伤的危险因素中，具有感染引发某种疾病的潜在危险。然而紧张、繁重、高风险的工作，使她们忽略了自我保护。现就助产士职业感染的因素及预防措施进行综述，旨在引起相关人员的重视，在提高医疗护理质量的同时，维护助产士的健康。