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The Use of Scorecards to Improve Documentation of Obstetrical Blood Loss.

机译：使用记分卡来改善产科失血的记录。

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摘要

Obstetric hemorrhage is one of the most common causes of maternal morbidity and mortality. The measurement of quantitative blood loss (QBL) at delivery prevents clinicians from failing to recognize hemorrhage in healthy obstetric patients who initially compensate for excessive blood loss. The purpose of this project was to improve the compliance of labor and delivery nurses in a community hospital with consistent QBL measurement. Key theories that formed the basis for the project were Lewin's theory of planned change and homeostasis. The project question addressed was: Is the use of weekly scorecards to provide feedback to nurses with both blinded individual data and aggregate unit data associated with an increase in the percent of patients with blood loss at delivery documented as a QBL measurement over a 12-week period of time? A blinded scorecard of the percent of deliveries attended by each nurse that had QBL documented and an aggregate run chart of the percent of all deliveries with QBL documented were posted in the unit weekly. The postings included discussions of means to enhance facilitators of and decrease barriers to QBL measurement. Over 12 weeks, the percent of deliveries with QBL documented increased from 22.7% to 80.0%. This result is consistent with previous reports that clear and objective feedback from scorecards is associated with improvement in performance. Scorecard feedback may be explored to determine if it is associated with improvement of other nursing practices. This project has implications for positive social change as it may contribute to a reduction in preventable maternal deaths. Decreasing maternal morbidity and mortality supports the health of women in a population and influences the health of the next generation.
机译：产科出血是孕产妇发病和死亡的最常见原因之一。在分娩时进行定量失血（QBL）的测量可防止临床医生无法识别健康的产科患者的出血，而这些患者最初可以弥补过多的失血。该项目的目的是通过一致的QBL评估来提高社区医院的分娩护士的依从性。构成该项目基础的关键理论是Lewin的计划变更和动态平衡理论。解决的项目问题是：是否使用每周记分卡向护士提供反馈，包括双盲的个人数据和汇总的单位数据，这些数据与分娩时失血患者百分比的增加相关，记录为12周的QBL量度一段的时间？每周在该病房中发布一个盲目记分卡，记录每个已记录QBL的护士的分娩百分比，并汇总记录所有已记录QBL的分娩百分比的运行图。帖子中讨论了增强QBL测量的便利性并减少其障碍的方法。在过去的12周中，有QBL记录的交货百分比从22.7％增加到80.0％。该结果与以前的报告一致，即记分卡的清晰客观的反馈与绩效的提高相关。可以探索记分卡反馈，以确定它是否与其他护理实践的改善相关。该项目可能对积极的社会变革产生影响，因为它可能有助于减少可预防的孕产妇死亡。孕产妇发病率和死亡率的下降支持人口中妇女的健康，并影响下一代的健康。

著录项

  • 作者

    Steinberg, Marilyn Cejka.;

  • 作者单位

    Walden University.;

  • 授予单位 Walden University.;
  • 学科 Nursing.;Health sciences.;Obstetrics.
  • 学位 D.N.P.
  • 年度 2018
  • 页码 86 p.
  • 总页数 86
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 建筑科学;
  • 关键词

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