Implementation of NICE recommendation for a policy of routine antenatal anti-D prophylaxis: a survey of UK maternity units
Implementation of NICE recommendation for a policy of routine antenatal anti-D prophylaxis: a survey of UK maternity units
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DOI：
10.1111/j.1365-3148.2008.00882.x
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发表时间：
2008-10-01
影响因子：
1.5
通讯作者：
Warner, P.
中科院分区：
文献类型：
--
作者：
Harkness, M.;Freer, Y.;Warner, P.
这项研究的目的是确定有多少英国产科医院实施了国家临床卓越研究所(NICE)对常规产前抗-D预防(RAADP)的指导。2002年5月，NICE推荐了一项针对RhD阴性孕妇的RAADP政策。该政策有可能降低产妇的敏感度，防止胎儿和新生儿死于溶血性疾病，但执行起来面临相当大的临床、财政和组织挑战。2005年完成了对英国所有324个产科单元的邮寄调查。收到了91%的答复(324个单位中的294个)。294人中有220人(75%)提供了RAADP，在英格兰和威尔士，19%的人提供了单剂方案。在12%的产妇单位，提供了常规的父亲血型检测。对于84%的产科单位，在实施时提供了工作人员教育。97%的产科病房提供了书面病人信息，217个产科病房中有147个(69%)退还了副本。我们收到了60份不同的传单。在NICE指南发布三年后，四分之一的产科病房没有提供RAADP。在那些确实提供RAADP的公司中，在抗D管理、父亲检测、提供书面信息和工作人员教育方面的做法各不相同。需要进行单位和临床医生水平的研究来了解原因。
The aim of this study was to determine how many UK maternity units have implemented National Institute for Clinical Excellence (NICE) guidance for routine antenatal anti-D prophylaxis (RAADP). In May 2002, the NICE recommended a policy of RAADP for RhD-negative pregnant women. The policy has the potential to reduce maternal sensitization and prevent deaths from haemolytic disease of the foetus and newborn, but implementation entails considerable clinical, financial and organizational challenges. A postal survey of all 324 UK maternity units was completed in 2005. Responses were received from 91% of units (294 of 324). RAADP was offered by 220 of 294 (75%) and in England and Wales 19% of those offered a single-dose regime. At 12% of maternity units, routine paternal blood group testing was offered. For 84% of maternity units, staff education was offered at the time of implementation. Written patient information was provided at 97% of maternity units and 147 of 217 (69%) returned a copy. We received 60 different leaflets. Three years after NICE guidance was issued, one in four maternity units did not offer RAADP. Among those that do offer RAADP, practice with regard to anti-D administration, paternal testing, provision of written information and staff education varied. Unit and clinician level research is required to understand why.