Standardisation of neonatal clinical practice
Standardisation of neonatal clinical practice
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DOI：
10.1111/1471-0528.12312
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发表时间：
2013-09-01
影响因子：
5.8
通讯作者：
Paul, V.
中科院分区：
文献类型：
--
作者：
Bhutta, Z. A.;Giuliani, F.;Paul, V.
21世纪国际胎儿和新生儿生长联盟（INTERGROWTH-21）是一个大规模、以人口为基础的多中心项目，涉及来自八个地理位置不同的国家的卫生机构，旨在评估最佳条件下的胎儿、新生儿和早产儿生长。鉴于该项目的多中心性质和预期的早产数量，至关重要的是，所有中心都遵循相同的标准化临床护理协议来评估和管理早产儿，以确保最终标准作为生长和营养指标的最大有效性，并将混淆降至最低。此外，众所周知，循证临床实践指南可以减少提供不适当的护理，并支持将新知识引入临床实践。INTERGROWTH-21新生儿小组编写了一份操作手册，其中反映了小组成员就新生儿发病率的标准化定义和参与该项目的所有中心提供的最低护理标准达成的共识。业务定义和简要管理议定书是通过德尔菲程序在权威机构对有关准则和管理议定书进行系统审查的基础上协商一致制定的。本文介绍了制定基本新生儿护理手册的过程，以及适用于所有INTERGROWTH-21参与中心的发病率定义和标准化新生儿护理协议。最后，提出了有关实施策略的思考。
The International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) is a large-scale, population-based, multicentre project involving health institutions from eight geographically diverse countries, which aims to assess fetal, newborn and preterm growth under optimal conditions. Given the multicentre nature of the project and the expected number of preterm births, it is vital that all centres follow the same standardised clinical care protocols to assess and manage preterm infants, so as to ensure maximum validity of the resulting standards as indicators of growth and nutrition with minimal confounding. Moreover, it is well known that evidence-based clinical practice guidelines can reduce the delivery of inappropriate care and support the introduction of new knowledge into clinical practice. The INTERGROWTH-21st Neonatal Group produced an operations manual, which reflects the consensus reached by members of the group regarding standardised definitions of neonatal morbidities and the minimum standards of care to be provided by all centres taking part in the project. The operational definitions and summary management protocols were developed by consensus through a Delphi process based on systematic reviews of relevant guidelines and management protocols by authoritative bodies. This paper describes the process of developing the Basic Neonatal Care Manual, as well as the morbidity definitions and standardised neonatal care protocols applied across all the INTERGROWTH-21st participating centres. Finally, thoughts about implementation strategies are presented.