Abstract:

Objective To implement evidence-based practice of breast milk expression behaviors among postpartum women with neonatal-maternal separation and explore its influences on lactation. Methods Evidence-based nursing was used to obtain best evidence. The model of evidence-based continuous quality improvement was adopted as the theoretical framework. From May to December 2018,the best evidence was applied to separated mothers according to four stages：evidence acquisition,current situation review,evidence introduction and effect evaluation. The changes of breast milk expression compliance and lactation volume were observed before and after the application of evidence. Results A total of 12 items of evidence were applied. Breast milk expression compliance was improved after evidence implementation. The number of women who transported breast milk to neonatology department increased. The initial time of breast milk transportation after delivery was brought forward. The total estimated lactation volume per woman in the first seven days after delivery was increased. Conclusion Evidence-based nursing is useful to manage breast milk expression behaviors among postpartum women with neonatal-maternal separation,optimize lactation success and increase the amount of milk,which can provide references for breastfeeding management for women with neonatal-maternal separation.

Key words: Neonatal-Maternal Separation, Milk Expression, Evidence-Based Practice, Continued Quality Improvement, Obstetrical Nursing

摘要：

目的 实施母婴分离产妇母乳采集的循证实践并探索其对泌乳的影响。方法 应用循证护理的方法获取最佳证据,以基于证据的持续质量改进模式为理论框架,于2018年5月—12月,按照证据获取、现状审查、证据引入和效果评价4个阶段将循证实践应用于母婴分离产妇,比较循证实践应用前后产妇母乳采集的依从性和泌乳量等指标的变化。结果 循证实践应用了12条证据。循证实践后,产妇母乳采集的依从性提高,送母乳至新生儿科的产妇人数比例提高,产妇开始送母乳时间提前,产后1周内产妇泌乳总量增加。结论 通过循证护理对母婴分离产妇进行管理,可有效规范产妇母乳采集行为,促进成功泌乳及提高泌乳量,可为母婴分离状态下母乳喂养的管理提供参考。

关键词: 母婴分离, 母乳采集, 循证实践, 持续质量改进, 产科护理