摘要
目的 将现有的与乳房胀痛预防和管理相关的最佳证据应用到护理实践,以促进产妇成功母乳喂养.方法 采用JBI临床证据实践应用系统（PACES）,基于现有的最佳证据,制定了6条审查标准,将证据融入护理常规,在1个产后病房开展为期12周的质量审查与流程再造.结果 第2轮审查时6条审查标准均达到100％,除第6条标准仅提高3％外,其余标准提高了30％～60％;产妇乳房胀痛预防与处理知识得分从15.6分提高至18.6分,哺乳技能得分从8.1分提升至8.8分.结论 基于循证的质量审查项目显著改善了产后妇女乳房胀痛预防和管理的临床护理实践,但仍需要进行持续质量审查,以不断提高护理质量.
Objective To integrate the best available evidence of breast engorgement prevention and management into practice and to increase breastfeeding rates.Methods This project utilized a pre-and post-implementation audit strategy using the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research Into Practice programs.It was completed in a series of stages over a 12-week period in an obstetric ward.The audit included six criteria recommended by the Joanna Briggs Institute.Results All criteria rated 100％ compliance in the re-audit,and 5 of them showed a 30％-60％ improvement except the criterion of on-demand breast feeding with only 3％ increase.Knowledge of prevention and management of breast engorgement in postpartum women increased from 15.6 points to 18.6 points,and their breastfeeding skills scored 8.1 in the first audit and 8.8 in the re-audit.Conclusion The evidence-based audits can effectively improve clinical practice of prevention and management of breast engorgement in postpartum women.Continuous audits should be conducted to achieve continuous quality improvement.
基金
复旦大学护理科研基金项目(SLF400001)
关键词
产妇
乳房胀痛
循证护理
最佳实践
质量审查
postpartum women
breast engorgement
evidence based nursing
best practice
an audit project
