江苏省107所医疗机构助产士门诊开展现状的调查研究

doi:10.3761/j.issn.0254-1769.2022.17.012

摘要/Abstract

摘要：

目的了解江苏省医疗机构助产士门诊的开展现状,并分析影响其开展的因素,为今后助产士门诊的建设及相关服务政策的制订提供参考依据。方法 2021年1月采用自行设计的江苏省医疗机构助产士门诊开展现状调查表,对江苏省13个城市,共116所二级及以上医疗机构的助产士门诊开展现状进行调查。结果最终,107所医疗机构完成调查,开展助产士门诊的医疗机构有48所（44.86%）,其中11所（22.92%）每周只开诊4 h。妇幼保健类专科医院开设助产士门诊的比例和每周开诊时间高于综合性医院,三级医院开设助产士门诊的比例高于二级医院（P<0.05）;三级医院、妇幼保健类专科医院的出诊者学历较高（P<0.05）;妇幼保健类专科医院开始介入管理的孕周较早、开展模拟分娩较多（P<0.05）。所有已开设助产士门诊的医疗机构都没有专门配套的电子病历系统。影响59所医疗机构未开设助产士门诊的前3个原因是：没有医院政策支持、人员不足、不知道如何开展。结论助产士门诊在江苏省医疗机构中普及率不足50%,应加大综合性医院、二级医院助产士门诊的普及率;增加已开设助产士门诊医疗机构的门诊开诊时间、提高开诊质量,加快建设助产士门诊电子病历系统。建议在人力资源、出诊时间、软件信息、质量控制等政策上提供进一步支持和监督。

关键词: 助产士门诊, 问卷调查, 横断面研究, 护理管理研究

Abstract:

Objective To understand the current situation of the development and operation of midwifery clinics in Jiangsu Province,and to analyze the factors that affect the opening of midwifery clinics,so as to provide references for the construction of midwifery clinics and policy formulation of related service systems in the future. Methods From January 2021,a self-designed questionnaire on the development status of midwives outpatient clinics in Jiangsu Province was used to investigate the development status of midwives outpatient clinics in 107 secondary and above medical institutions in 13 cities in Jiangsu Province. Results Among the 107 hospitals,48（44.86%） offered midwifery outpatient clinics;11（22.92%） hospitals only opened clinics for 4 hours per week. The proportion of midwife outpatient clinics and weekly outpatient visits in specialized maternal and child health care hospitals were higher than those in general hospitals,and the proportion of midwifery outpatient clinics in tertiary hospitals was higher than that in secondary hospitals（P<0.05）. The visiting staff of tertiary hospitals and specialized maternal and child health care hospitals are highly educated（P<0.05）. Maternal and child health care specialized hospitals started intervention management earlier in gestational age,and carry out simulated delivery more often（P<0.05）. All hospitals with midwifery clinics do not have a dedicated electronic medical record system. The top 3 influencing factors for not opening midwifery outpatient clinics in 59 hospitals are the lack of hospital policy support,insufficient staff,and not knowing how to conduct them. Conclusion The prevalence rate of midwives outpatient clinics in medical institutions in Jiangsu Province is less than 50%;the prevalence rate of midwives outpatient clinics in general hospitals and secondary hospitals should be increased;the time and quality of outpatient consultations in hospitals with midwifery outpatient clinics should be accelerated;the establishment of the outpatient electronic medical record system in midwives clinics should be accelerated. It is recommended to provide further support and supervision on policies such as human resources,visiting hours,software information,quality control,et al.

Key words: Midwife Outpatient Service, Questionnaire Survey, Cross-Sectional Study, Nursing Administration Research

叶宁, 周春秀, 周文胜, 李六兰, 刘婧岩, 王岚, 朱珠. 江苏省107所医疗机构助产士门诊开展现状的调查研究[J]. 中华护理杂志, 2022, 57(17): 2123-2129.

YE Ning, ZHOU Chunxiu, ZHOU Wensheng, LI Liulan, LIU Jingyan, WANG Lan, ZHU Zhu. Investigation and study on the current situation of midwife clinics in midwifery institutions in Jiangsu Province[J]. Chinese Journal of Nursing, 2022, 57(17): 2123-2129.

图/表 4

表1 江苏省医疗机构助产士门诊的一般情况（n=107）

Table 1 General information of midwife clinics in medical institutions in Jiangsu Province（n=107）

表2 江苏省医疗机构助产士门诊出诊人员情况[所（百分比,%）,n=48]

Table 2 The situation of attendants in the midwife clinic of medical institutions in Jiangsu Province [case（percentage,%）,n=48]

表3 江苏省医疗机构助产士门诊设施配备情况[所（百分比/率,%）,n=48]

Table 3 Outpatient facilities for midwives in medical institutions in Jiangsu Province[case（percentage,%）,n=48]

表4 江苏省医疗机构助产士门诊运行现况[所（百分比/率,%）,n=48]

Table 4 Status of midwife clinic operation in medical institutions in Jiangsu Province[case（percentage,%）,n=48]

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