Development of quality indicators for low-risk labor care provided by midwives using a RAND-modified Delphi method.
Development of quality indicators for low-risk labor care provided by midwives using a RAND-modified Delphi method.
复制标题
使用兰德公司修改的德尔菲法制定助产士提供的低风险分娩护理的质量指标。
DOI：
10.1186/s12884-017-1468-4
复制
发表时间：
2017-09-22
影响因子：
3.1
通讯作者：
Nakayama T
中科院分区：
文献类型：
--
作者：
Ueda K;Ohtera S;Kaso M;Nakayama T
在分娩方面，大多数分娩是低风险的，定义为足月自然分娩，没有特殊的高风险因素或并发症，特别是在产妇和围产期死亡率非常低的资源丰富的国家。事实上，大多数母亲和婴儿在分娩过程中没有严重的疾病。然而，所提供的护理质量并不能得到保证，其表现可能因分娩设施和提供者而异。在世界上的一些地方，在分娩过程中过度使用技术几乎肯定是基于这样的假设：“随时都有可能出问题。”有必要评估为低风险分娩的母亲和婴儿提供的护理质量。我们的目的是为主要由日本助产士提供的低风险分娩护理制定具体的质量指标。我们使用了rand修正的德尔菲法，该方法将证据审查与专家共识的形成相结合。该程序包括五个步骤：(1)文献综述，包括临床实践指南，提取和开发质量指标候选；(2)组建多学科小组；(3)独立小组评级（第一轮）；(4)小组会议和独立小组评级（第二轮）；(5)独立小组评级（第三轮）。三个独立的小组评级（1-3轮）在2012年7月至12月期间进行。这个多学科小组由8名临床医生（2名儿科医生、3名产科医生和3名助产士）和3名非临床医生的母亲组成。证据评价从32项临床实践指南中提取了166项关键建议，并增加了31项现有质量指标。在排除重复的建议和质量指标后，小组讨论了25个候选指标。其中，会议通过18条，修改1条，未通过6条，增加4条。我们为日本产房助产士提供的低风险分娩护理建立了23项质量指标。
In childbirth, most deliveries are low-risk, defined as spontaneous labor at full term without special high-risk facts or complications, especially in high-resource countries where maternal and perinatal mortality rates are very low. Indeed, the majority of mothers and infants have no serious conditions during labor. However, the quality of care provided is not assured, and performance may vary by birthing facility and provider. The overuse of technology in childbirth in some parts of the world is almost certainly based on assumptions like, “something can go wrong at any minute.” There is a need to assess the quality of care provided for mothers and infants in low-risk labor. We aimed to develop specific quality indicators for low-risk labor care provided primarily by midwives in Japan. We used a RAND-modified Delphi method, which integrates evidence review with expert consensus development. The procedure comprises five steps: (1) literature review, including clinical practice guidelines, to extract and develop quality indicator candidates; (2) formation of a multidisciplinary panel; (3) independent panel ratings (Round 1); (4) panel meeting and independent panel ratings (Round 2); and (5) independent panel ratings (Round 3). The three independent panel ratings (Rounds 1–3) were held between July and December 2012. The assembled multidisciplinary panel comprised eight clinicians (two pediatricians, three obstetricians, and three midwives) and three mothers who were nonclinicians. Evidentiary review extracted 166 key recommendations from 32 clinical practice guidelines, and 31 existing quality indicators were added. After excluding duplicate recommendations and quality indicators, the panel discussed 25 candidate indicators. Of these, 18 were adopted, one was modified, six were not adopted, and four were added during the meeting, respectively. We established 23 quality indicators for low-risk labor care provided by midwives in labor units in Japan.
登录
查看更多内容
影响因子：
120.7
作者：
Howell, Elizabeth A.;Zeitlin, Jennifer;Hebert, Paul L.;Balbierz, Amy;Egorova, Natalia
通讯作者：
Egorova, Natalia
DOI：
10.1111/j.1552-6909.2006.00105.x
发表时间：
2006-11-01
影响因子：
1.8
作者：
Murphy, Patricia Aikins;Fullerton, Judith T.
通讯作者：
Fullerton, Judith T.
影响因子：
2.2
作者：
Kötter T;Schaefer FA;Scherer M;Blozik E
通讯作者：
Blozik E
影响因子：
37.8
作者：
Spertus, JA;Eagle, KA;Normand, SLT
通讯作者：
Normand, SLT
影响因子：
3.7
作者：
Boulkedid, Rym;Sibony, Olivier;Alberti, Corinne
通讯作者：
Alberti, Corinne