SIXTY YEARS OF NURSE MIDWIFERY: PRACTICE-OUTCOME ANALYSI

护士助产六十年：实践结果分析

• 批准号: 3391621
• 负责人: CLAIRE M ANDREWS
• 金额: $ 20.84万
• 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 1990-11-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3391621
• 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.

这项研究的具体目的是：（a）描述人口 接受护士提供的产妇护理的妇女人数- 60年来边境护理服务（FNS）的助产士 （B）比较怀孕情况 国家接受的参数方面的成果， 评价产妇保健质量， 发病率-死亡率和围产期发病率和死亡率 率;及（c）描绘和描述护士助产的做法， 自1925年以来在FNS的演变。 研究问题包括：（1）什么是FNS的比较 母婴结局与相关县、州和国家 从1999年到2000年， 1925年至1985年？ (2)FNS护士之间的关系是什么- 助产实践和母婴结局。 与22，000例由护士-助产士管理的分娩有关的信息 B将从缩微胶片医疗记录中提取 从1925年到现在分娩的妇女人数。 概率样本将由分层随机样本组成 的记录。 地层将是年，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 将在每个时间段进行评估。 评价者间信度 研究助理也将被计算在内。 研究助理将直接从缩微胶片输入数据 记录到电脑上。 一种无纸化数据输入工具， 使用格式化的“屏幕出现在监视器上，使数据 直接记录在计算机上， 准确的方式。 质量控制措施和清洁 数据集将会出现。 描述性统计将记录护士助产实践。 将使用S统计学方法进行统计分析。 由AT & T贝尔实验室开发的软件包。 用于比较交货地点和交货情况的合计数 将以十年为间隔进行定义，并将比较 FNS结果与基线区域，州和国家数字 大致相同的时间段。 时间关系 FNS服务人群的关键结果， 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。