Effect of a perinatal care quality improvement package on patient satisfaction: a secondary outcome analysis of a cluster-randomised controlled trial.
Effect of a perinatal care quality improvement package on patient satisfaction: a secondary outcome analysis of a cluster-randomised controlled trial.
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围产期护理质量改进包对患者满意度的影响：一项随机分组对照试验的次要结局分析
DOI：
10.1136/bmjopen-2021-054544
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发表时间：
2022-06-06
期刊：
影响因子：
2.9
通讯作者：
Malqvist, Mats
中科院分区：
文献类型：
--
作者：
Brunell, Olivia;Chaulagain, Dipak;Ashish, K. C.;Bergstrom, Anna;Malqvist, Mats
探讨质量改进（QI）包对围产期护理患者满意度的影响。一项阶梯楔形随机分组对照试验的次要分析。参与的医院按规模随机分为四个不同的楔形。尼泊尔12家二级公立医院。孕龄≥22周在医院分娩，入院时有胎心音的女性。排除不良结局。一家医院因数据不完整而被排除，四家低容量医院因异质性大而被排除。最终分析包括54 919名妇女。医院管理层参与进来，并从医院内部招聘了调解人。在每家医院评估了现有的围产期护理，随后举办了瓶颈分析讲习班。为参与围产期护理的卫生工作者开展了为期3天的新生儿基本护理培训，并引入了一套用于日常实践的质量保证工具（技能检查、自我评估清单、记分板和每周计划-实施-学习-行动会议）。6个月后进行复习训练。妇女对分娩期间护理的满意度（预先设定的次要结局）。干预后，妇女对分娩期间护理总体满意的可能性增加（调整后OR（aOR）：1.66，95%CI：1.59至1.73）。然而，总体满意度的比例较低（对照组58%，干预组62%）。干预后，女性更可能对卫生工作者提供的教育和信息感到满意（aOR：1.34，95% CI：1.29至1.40），并受到尊严和尊重（aOR：1.81，95% CI：1.52至2.16）。住院期间遭受虐待的可能性降低（aOR：0.42，95% CI：0.34 - 0.51），对隐私水平感到满意的可能性增加（aOR：1.14，95% CI：1.09 - 1.18）。在引入围产期护理质量保证一揽子计划后，患者满意度有所提高。我们建议进一步研究哪些方面的护理是最重要的，以提高妇女对尼泊尔医院围产期护理的满意度。ISRCTN30829654。
To investigate the effect of a quality improvement (QI) package on patient satisfaction of perinatal care. Secondary analysis of a stepped-wedge cluster-randomised controlled trial. Participating hospitals were randomised by size into four different wedges. 12 secondary-level public hospitals in Nepal. Women who gave birth in the hospitals at a gestational age of ≥22 weeks, with fetal heart sound at admission. Adverse outcomes were excluded. One hospital was excluded due to data incompleteness and four low-volume hospitals due to large heterogeneity. The final analysis included 54 919 women. Hospital management was engaged and facilitators were recruited from within hospitals. Available perinatal care was assessed in each hospital, followed by a bottle-neck analysis workshop. A 3-day training in essential newborn care was carried out for health workers involved in perinatal care, and a set of QI tools were introduced to be used in everyday practice (skill-checks, self-assessment checklists, scoreboards and weekly Plan–Do–Study–Act meetings). Refresher training after 6 months. Women’s satisfaction with care during childbirth (a prespecified secondary outcome). The likelihood of women being overall satisfied with care during childbirth increased after the intervention (adjusted OR (aOR): 1.66, 95% CI: 1.59 to 1.73). However, the proportions of overall satisfaction were low (control 58%, intervention 62%). Women were more likely to be satisfied with education and information from health workers after intervention (aOR: 1.34, 95% CI: 1.29 to 1.40) and to have been treated with dignity and respect (aOR: 1.81, 95% CI: 1.52 to 2.16). The likelihood of having experienced abuse during the hospital stay decreased (aOR: 0.42, 95% CI: 0.34 to 0.51) and of being satisfied with the level of privacy increased (aOR: 1.14, 95% CI: 1.09 to 1.18). Improvements in patient satisfaction were indicated after the introduction of a QI-package on perinatal care. We recommend further studies on which aspects of care are most important to improve women’s satisfaction of perinatal care in hospitals in Nepal. ISRCTN30829654.
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DOI：
10.1016/s0140-6736(18)31668-4
发表时间：
2018-11-17
期刊：
Lancet (London, England)
影响因子：
--
作者：
Kruk ME;Gage AD;Joseph NT;Danaei G;García-Saisó S;Salomon JA
通讯作者：
Salomon JA
影响因子：
8
作者：
Goudar, Shivaprasad S.;Somannavar, Manjunath S.;Singhal, Nalini
通讯作者：
Singhal, Nalini
影响因子：
2.9
作者：
Doyle C;Lennox L;Bell D
通讯作者：
Bell D
影响因子：
5.4
作者：
Bjertnaes, Oyvind A.;Sjetne, Ingeborg Stromseng;Iversen, Hilde Hestad
通讯作者：
Iversen, Hilde Hestad
影响因子：
2.5
作者：
LUMLEY, J
通讯作者：
LUMLEY, J