Tuân thủ qui trình chăm sóc thiết yếu bà mẹ, trẻ sơ sinh trong và ngay sau đẻ thường tại Khoa Sản, Bệnh viện Đa khoa tỉnh Đồng Tháp, năm 2021

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Tác giả: Thanh Hương Nguyễn, Thị Kim Phụng Tống

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Khoa học Nghiên cứu Sức khỏe và Phát triển, 2022

Mô tả vật lý: tr.34-42

Bộ sưu tập: Metadata

ID: 336945

Thêm vào giỏ Liên kết toàn văn

Mục tiêu: Mô tả thực trạng và một số yếu tố ảnh hưởng đến tuân thủ qui trình chăm sóc thiết yếu bà mẹ và trẻ sơ sinh (CSTY BM-TSS) trong và ngay sau đẻ thường. Phương pháp nghiên cứu: Thiết kế cắt ngang, kết hợp định lượng và định tính. Số liệu định lượng thu thập qua quan sát trực tiếp 90 ca đẻ thường với bảng kiểm 40 bước của qui trình CSTY BM-TSS theo hướng dẫn của Bộ Y tế. Số liệu định tính được thu thập qua 4 cuộc phỏng vấn sâu cán bộ quản lý bệnh viện, khoa và 3 cuộc thảo luận nhóm với 22 hộ sinh. Số liệu định lượng được phân tích bằng thống kê mô tả. Số liệu định tính được ghi âm, gỡ băng và phân tích theo chủ đề. Kết quả: Tỉ lệ các ca đẻ thường được hộ sinh thực hiện đúng tất cả 40 bước của qui trình CSTY BM-TSS chỉ đạt 14,4%, đúng 35-39 bước là 55,6%, đúng 30-34 bước là 28,9% và vẫn còn 1,1% chỉ đúng 27-29 bước. Nghiên cứu định tính cho thấy yếu tố ảnh hưởng tích cực tới thực hiện qui trình là sự cam kết của lãnh đạo trong thực hiện qui trình, có đầu tư về trang thiết bị cũng như triển khai đào tạo về CSTY BMTSS. Yếu tố ảnh hưởng bất lợi tới tuân thủ qui trình là bất cập của qui trình, giám sát chưa hiệu quả, thiếu nhân lực và áp lực công việc lớn, thiếu phối hợp của các bà mẹ, người thân. Kết luận: Bệnh viện trước mắt cần rà soát hướng dẫn thực hiện qui trình và định kỳ thực hiện việc giám sát hiệu quả hơn, cải thiện quản lý nhân lực của Khoa Sản
đẩy mạnh truyền thông/tư vấn cho bà mẹ, người thân để phối hợp thực hiện qui trình.Objectives: Describe the adherence to the early essential newborn care (EENC) guidelines in normal deliveries and influencing factors at Dong Thap General Hospital. Methods: This is cross-sectional study design applying mixed method. Quantitative data was collected by observing 90 normal deliveries using checklist following 40 steps of EENC procedure guideline of the Ministry of Health. Qualitative data were collected from 26 key informants including 4 in-depth interviews (IDIs) with Hospital managers and 3 focus group discussions (FGDs) with midwives. Quantitative data was analyzed using descriptive statistics. Qualitative data was recorded, transcribed, and analyzed by thematic coding. Results: The rate of 90 normal births that were fully adhered to all 40 steps of the EENC procedure by midwives was only 14.4%. The rate correctly following 35-39 steps was 55.6%, 30-34 steps was 28.9%, and 27- 29 steps was 1.1%. Qualitative data showed that factors positively influenced the adherence to the EENC were managers’ commitment to implement the guideline, infrastructure investment, training on EENC for staff. Whereas, factors negative affected the adherence to the EENC were inappropriate procedure, ineffective supervision and monitoring, the lack of human resources and heavy workload, and lack of collaboration of mothers. Recommendations: Dong Thap General Hospital needs to review the content of the procedure, periodically to conduct more effective supervision and monitoring, improve workforce management at Obstetric Department to ensure the implementation of the procedure
promote communication/counseling for mothers and relatives to collaborate with midwives in implementing the EENC procedure.

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