提升剖腹產執行親子肌膚接觸完整率

To Promote the Completion Rate of Mother-baby Skin Contact in the Cesarean Section

邱春花(Chuen-Hua Chiou) ； 楊月霞(Yueh-Hsia Yang) ； 尹徽音(Huei-Ying Yin)

《北市醫學雜誌》 6卷6期 (2009/12) Pp. 489-502

摘要

執行親子皮膚接觸為國民健康局重要政策，本專案旨在提升手術室流動護士執行親子皮膚接觸之完整率，本院配合政策執行不限地點於產後半小時內將新生兒放在母親胸前進行皮膚與皮膚直接接觸至少十分鐘。2008年8月15日至31日以觀察、訪談、問卷及按馬錶計時方式收集資料確立問題，結果發現完整率低至47.1%，流動護士僅做到讓母親碰觸嬰兒臉頰、握握小手，實際皮膚接觸未達十分鐘。分析原因有：標準作業流程不完整、手術室內溫度太冷、手術台上執行親子皮膚接觸位置太小、醫師認為不重要及手術中同仁分身乏術等項，經制定標準作業流程、增設保溫設備、安排在職教育及協商溝通等方案介入後，使手術室親子皮膚接觸完整率提升至85.4%進而提升手術室護理品質。

關鍵字

剖腹產 ； 皮膚與皮膚接觸 ； 母嬰親善醫院

並列摘要

Insurance Bureau that parent-child skin contact with a newborn should occur. This project aims to promote the completion rate for parent-child skin contact, which is brought about by circulating nurses. In order that this policy is correctly implemented, it is necessary that the baby be placed in mother's bosom for at least for 10 minutes within 30 minutes of the baby's birth. From August 15 to August 31 in 2008, we collected data on this activity by observation, interviews, questionnaires and time measurement. We found that the completion rate was low at 47.1%. In general, the circulating nurses just let the mothers touch the babies' cheeks and hands and the actual time of skin contact was usually less than 10 minutes. The reasons for this failure rate were analysed and found to be an imperfect standard procedure, the low temperature of the operation room, a lack of an appropriate area for skin contact on delivery table, the doctor's ignorance, and busy staff. We ameliorated the situation by setting up a Standard Operating Procedure, increasing the temperature in the operation room and arranging for staff education and improving negotiation. The completion rate for parentchild skin contact in the operation room was elevated to 85.4% after implementation of these measures and therefore the nursing quality in the operation room was greatly improved.

並列關鍵字

caesarean section ； skin-to-skin contact ； baby friendly hospital