目的 研究教练式培训在新生儿早期基本保健技术推广中的应用及效果,为今后临床开展各项培训提供新的方法和思路。方法 在北京、陕西省和四川省各选择1所省级医疗保健机构和1所地市级医疗保健机构作为试点单位,医务人员接受2 d教练式培训,比较研究对象培训前后新生儿保健理论知识的得分、洗手情况以及对于出生时有自主呼吸和无自主呼吸新生儿临床操作技能的得分情况。培训3个月后,每个试点医院随机抽样10名产妇进行出院前访谈,分析干预后各项新生儿保健措施的实施情况。结果 培训后医务人员的理论知识得分(16.82±1.00)较培训前显著提高(11.90±2.68)(P<0.001)。三省及总体培训后洗手操作技能均提高,手部清洁程度显著改善(P<0.001)。培训后有呼吸和无呼吸新生儿操作技能得分中位数分别为41分和58分。培训3个月后,87%(52/60)的产妇分娩后进行了母婴皮肤接触,分娩后1 min内开始母婴皮肤接触率为55%(33/60),皮肤接触持续90 min的占47%(28/60);出院前母乳喂养率达到77%(46/60),纯母乳喂养率为48%(29/60)。结论 新生儿早期基本保健技术的教练式培训方法效果较好,培训后医务人员能迅速掌握正确的操作技能,有利于促进新技术在临床上的推广和使用。
Abstract
Objective To study on application and effects of coaching in popularizing early essential newborn care guideline and provide clinical training with new idea and method. Methods One province level and one district level maternal and child health hospital in Beijing,Shaanxi and Sichuan were chosen as pilot hospitals.Healthcare professionals were coached during 2 days.The effects were analyzed by comparing the score of theoretical knowledge,practice on washing hands and delivery practice for the breathing baby and non-breathing baby before and after coaching.3 months after coaching,10 maternal were randomly sampled for interviews every hospital to analyze the implementation of neonatal health care measures after intervention. Results Total healthcare professionals got higher score after coaching(16.82±1.00) than before (11.90±2.68)(P<0.001).Healthcare professionals in Beijing,Shaanxi and Sichuan all improved the skills of washing hands, and cleanliness of hands improved significantly(P<0.001).The median score of delivery practice for the breathing baby and non-breathing baby was 41 and 58.After 3 months,87% (52/60) of mothers had skin-to-skin contact with newborns after childbirth,and the mother-to-child skin contact rate was 55% (33/60) within one minute after childbirth,and skin contact continued for 90 minutes accounting for 47% (28/60);breastfeeding rate before discharge reached 77% (46/60),exclusive breastfeeding rate was 48% (29/60). Conclusion sCoaching can be effectively used in early essential newborn care and can help healthcare professionals understand and use early essential newborn care guideline well.Coaching should be populated in future clinical practices.
关键词
新生儿 /
基本保健 /
教练式培训 /
效果评价
Key words
newborn /
essential care /
coaching /
effect evaluation
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