60 YEARS OF NURSE MIDWIFERY: PRACTICE-OUTCOME ANALYSIS

助产护士 60 年：实践结果分析

• 批准号: 3391627
• 负责人: CLAIRE M ANDREWS
• 金额: $ 15.64万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1987
• 资助国家: 美国
• 起止时间: 1987-08-15 至 1991-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3391627
• 关键词: health care professional practice; health care service evaluation; history of life science; human morbidity; human mortality; infant mortality; medical records; mother /infant health care; nursing care evaluation; nursing research

The specific aims of this study are to: (a) describe the population of women receiving maternity care provided by the nurse- midwives of the Frontier Nursing Service (FNS) in the 60 years since establishment of the service; (b) compare pregnancy outcomes in terms of nationally accepted parameters used to evaluate quality of maternity care as reflected by maternal morbidity - mortality rates and perinatal morbidity and mortality rates; and (c) depict and describe nurse midwifery practices and their evolution at the FNS since 1925. Research questions include: (1) What is the comparison of FNS maternal infant outcomes to relative county, state, and national maternal infant outcomes in ten year increments of time from 1925 to 1985? (2) What is the relationship between FNS nurse- midwifery practices and maternal infant outcomes.? Information related to 22,000 births managed by nurse-midwives at the FNS will b extracted from the microfiched medical records of women delivered in the years 1925 to the present. The probability sample will consist of a stratified random sample of records. Strata will be years and then time periods corresponding to changes in medical record design. Quantity and quality of data, as well as the optimal procedure for data entry will then be assessed for each time period. Interrater reliabilities on research assistants will also be calculated. Research assistants will enter data directly from the microfiched records to the computer. A paperless data entry tool, by which the use of formatted "screens appear on the monitor, enables data to be recorded directly on the computer in an efficient and accurate manner. Quality control measures and cleansing of the data set will occur. Descriptive statistics will document nurse-midwifery practices. Statistical analysis will be performed using the S statistical package developed by AT & T Bell Laboratories. Aggregations for comparisons for site and situation of delivery will be defined in terms of ten year intervals and will compare FNS outcomes to baseline regional, state, and national figures for the same approximate time period. The chronological relationship of key outcomes in the population served by the FNS to appropriate socioeconomic and environmental factors since 1925 will be shown in a graphical format.

本研究的具体目的是： (a) 描述人口 接受护士提供产妇护理的妇女人数 60 年来边境护理服务 (FNS) 的助产士 自服务成立以来； (b) 比较怀孕情况 根据国家认可的参数得出的结果 评估孕产妇所反映的孕产保健质量 发病率 - 死亡率和围产期发病率和死亡率 费率； (c) 描绘和描述护士助产实践以及 自 1925 年以来他们在 FNS 的演变。 研究问题包括：（1）FNS的比较是什么 母婴结局与相关县、州和国家的关系 母婴结局以十年为增量 1925 年至 1985 年？ (2) FNS 护士- 之间是什么关系？ 助产实践和母婴结局。？ 与护士兼助产士管理的 22,000 例分娩相关的信息 FNS 将从微缩医疗记录中提取 1925 年至今分娩的妇女人数。 概率样本将由分层随机样本组成 的记录。 分层将是年份，然后是时间段 与病历设计的变化相对应。 数量和 数据质量以及数据输入的最佳程序 然后将针对每个时间段进行评估。 评估者间的可靠性 研究助理的费用也将被计算在内。 研究助理将直接从缩微胶片输入数据 记录到电脑。 无纸化数据输入工具，通过它 使用格式化的“屏幕出现在监视器上，使数据 直接在计算机上高效录制 准确的方式。 质量控制措施和清洁 数据集就会发生。 描述性统计数据将记录护士助产实践。 统计分析将使用S统计进行 软件包由 AT&T 贝尔实验室开发。 用于比较交付地点和情况的聚合 将按照十年间隔进行定义，并将进行比较 FNS 结果以基线区域、州和国家数据为基础 相同的大致时间段。 时间顺序关系 FNS 所服务人群的主要成果 自 1925 年以来适当的社会经济和环境因素 将以图形格式显示。