Maternal near miss - towards a standard tool for monitoring quality of maternal health care
Maternal near miss - towards a standard tool for monitoring quality of maternal health care
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DOI：
10.1016/j.bpobgyn.2009.01.007
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发表时间：
2009-06-01
影响因子：
5.5
通讯作者：
Pattinson, Robert C.
中科院分区：
文献类型：
--
作者：
Say, Lale;Souza, Joao Paulo;Pattinson, Robert C.
在资源贫乏的环境中，孕产妇死亡率仍然是表现最差的健康指标之一。对于在卫生设施中发生的死亡，了解产科护理过程至关重要，以便解决系统内任何已确定的弱点或失败并采取纠正行动。然而，尽管产妇死亡是一个重大的公共卫生问题，但绝对数字很少，特别是在单个设施内。研究在怀孕、分娩或产后（产妇差点漏诊或严重急性产妇发病率）期间因并发症而几乎死亡但幸存的妇女的病例，日益被认为是检查产科护理质量的有用手段。然而，由于缺乏标准定义和统一的病例识别标准，这一概念在审查临床护理中的常规实施和更广泛应用受到限制。世卫组织启动了一项进程，商定了孕产妇险些漏诊病例的定义并制定了一套统一的识别标准，目的是促进对这些病例的审查，以监测和提高产科护理的质量。提出了一份识别标准清单和一个单一的定义。本文提出了产妇未遂病例的定义和鉴定标准。它还建议了在监测/评价产科护理质量方面实施产妇险些漏诊审计的程序。产妇险些错过概念的实际实施应对提高产科护理质量、减少产妇死亡和改善产妇保健作出重要贡献。(C) 2009年Elsevier Ltd.出版
Maternal mortality is still among the worst performing health indicators in resource-poor settings. For deaths occurring in health facilities, it is crucial to understand the processes of obstetric care in order to address any identified weakness or failure within the system and take corrective action. However, although a significant public health problem, maternal deaths are rare in absolute numbers especially within an individual facility. Studying cases of women who nearly died but survived a complication during pregnancy, childbirth or postpartum (maternal near miss or severe acute maternal morbidity) are increasingly recognized as useful means to examine quality of obstetric care. Nevertheless, routine implementation and wider application of this concept in reviewing clinical care has been limited due to the lack of a standard definition and uniform case-identification criteria. WHO has initiated a process in agreeing on a definition and developing a uniform set of identification criteria for maternal near miss cases aiming to facilitate the reviews of these cases for monitoring and improving quality of obstetric care. A list of identification criteria was proposed together with one single definition. This article presents the proposed definition and the identification criteria of maternal near miss cases. It also suggests procedures to make maternal near miss audits operational in monitoring/evaluating quality of obstetric care. The practical implementation of maternal near miss concept should provide an important contribution to improving quality of obstetric care to reduce maternal deaths and improve maternal health. (C) 2009 Published by Elsevier Ltd.