提升24小時親子同室率和改善純母乳哺餵之研究－以母嬰親善醫院為例

目的：親子同室增進產婦照護嬰兒之能力和親子關係，也是成功母乳哺餵關鍵。本研究24小時親子同室率明顯下降，由71.74%下降到45.16%，母乳哺育嬰兒的意願逐年下降，期藉本研究提升24小時親子同室率和純母乳哺餵，提供產後專業且以家庭為中心的護理，進而增加家庭的育兒技巧，讓產婦、新生兒在出院返家前做好完善的準備。方法：依研究的方法進行臨床照護問題的改善，明訂清楚目標，討論對策與檢討，以面對面訪談法、問卷調查、實地觀察、標準化稽核、常模比較以及規範、程序的審核等方法進行原因調查。運用特性要因圖和決策矩陣分析找出主要原因，擬訂對策。結果：確認問題為護理人員缺乏親子同室教育訓練及對親子同室認知不足；無專屬之母嬰親善個管師實際參與業務執行；產婦缺乏參與新生兒照顧，育兒技術不熟練；親子同室病室缺乏安全管控；缺乏完整統合的親子同室稽核制度。藉由明確策略，修訂照護標準、實施在職教育訓練、建置並執行稽核等，落實方案執行。評值策略之成效，親子同室執行率由45.16%提升至75%，遠高於全國和世界衛生組織的目標值，純母乳哺育率由2015年的平均47.97%上升至55.88%，同時、護理人員對親子同室認知及行為評核達100%。結論：本研究有效提升24小時親子同室率和純母乳哺育率，也建立親子同室照護標準程序，而提升病房安全及專業照護品質。

關鍵字

24小時親子同室率；純母乳哺餵；母嬰親善醫院；健康促進

並列摘要

Purpose: Rooming-in has been associated with a mother's ability to care for newborn and enhanced a maternal-infant relationship. Rooming-in is also a key to successful breastfeeding. The percentage of our hospital that reported 24 hours rooming-in rate decreased significantly from 71.74% to 45.16%. Breastfeeding rates have decreased over the past several years. Thus, the aims of this study were to increase rates of both rooming-in and exclusive breastfeeding for improving maternal or even parental competence and provide confirmation of their readiness to provide independent care at home. Methods: We applied the method of project management to derive clear purposes and effective strategies for the problems above. Face-to-face interview, survey, observation, standardized audit, norm comparison and reviews of clinical practice guidelines were used to analyze and find the possible causes. Cause and effect analysis diagram and decision-making matrix were also used. Results: The significantly influencing factors were found and included the lack of in-service training programs focused upon rooming-in for nurses, lack of adequate knowledge of rooming-in, lack of case manager for ideal rooming-in practices, mother's inability to care for newborns, insufficient safety and security management of rooming-in ward environment, and lack of integrated audit plan for nursing care based on implementation of the rooming-in standardized procedures. The schemes for problem-solving were developed and included strategies of establishment of protocols and standards related to rooming-in, implementation of in-service training and capacity building of rooming-in, and construction and implementation of nursing audit etc. After implementing the project, the rooming-in rate increased from 45.16% to 75% which is far above the average target values of World Health Organization. The rate of exclusive breastfeeding increased from 47.97% to 55.88% in 2015. All nurses (100%) attained the required knowledge and skills of rooming-in. Conclusions: This study effectively improve the rates of rooming-in and exclusive breastfeeding, and established clinical guidelines of rooming-in practice. The rooming-in environment safety and professional quality of care are increased.

並列關鍵字

24 hours rooming-in ； exclusive breastfeeding ； baby-friendly hospital ； health promotion

參考文獻

Hsieh K, Rimmer JH, Heller T. Obesity and associated factors in adults with intellectual disability. J Intellect Disabil Res 2013; 58: 851-63.

Einarsson IÓ, Ólafsson Á, Hinriksdóttir G, Jóhannsson E, Daly D, Arngrímsson SÁ. Differences in physical activity among youth with and without intellectual disability. Med Sci Sports Exerc 2014; 47: 411-8.

Oviedo GR, Tamulevicius N, Guerra-Balic M. Physical activity and sedentary time in active and non-active adults with intellectual disability: A comparative study. Int J Environ Res Public Health 2019; 16: E1761.

Stanish HI, Curtin C, Must A, Phillips S, Maslin M, Bandini LG. Does physical activity differ between youth with and without intellectual disabilities? Disabil Health J 2019; 12: 503-8.

Brooker K, van Dooren K, McPherson L, Lennox N, Ware R. A systematic review of interventions aiming to improve involvement in physical activity among adults with intellectual disability. J Phys Act Health 2015; 12: 434-44.

國際替代計量

提升24小時親子同室率和改善純母乳哺餵之研究－以母嬰親善醫院為例

全文下載

主題瀏覽