Objective To investigate the implementation and existing problems of the nursing service in the community postnatal family visits,and to provide practical assessment tools and theoretical basis for future improving the evaluation of nursing quality in community postnatal family visits through empirical research on the evaluation index system of nursing quality of postpartum family visits by community medical workers. Methods From October to December in 2016,18 community health service institutions were randomly selected from three districts in Yinchuan City according to a proportion of 3: 1. Based on the evaluation index system of nursing quality in community postpartum family visits and the combination of the current nursing status of community postpartum family visits,the members of the research group undertook field investigations and evaluations with corresponding designed evaluation scales and questionnaires. Site Inspection Scale of the Quality of Nursing Process in Community Postpartum Family Visits was used to evaluate the process quality evaluation,and Qualitative and Quantitative Evaluation Index Questionnaire of Nursing Service in Community Postpartum Family Visits,Questionnaire of Satisfaction of Nursing Workers in Community Postpartum Family Visits and Questionnaire of Satisfaction and Related Knowledge Status of Delivery Women wereapplied to assess the quality of the structure and result. The standard scores of each index were obtained after the conversion of the survey data,and then the scores of the nursing quality in the community postpartum family visits of each community health service institutions were calculated by the comprehensive scoring method of weighting and accumulation. Results Among the 18 community health service institutions,the number of doctors in the personnel of community postpartum family visits was zero,the number of community nurses was one,the annual training rate of the visiting staff,and the annual pass rate of theory and skill assessment were both zero;the constituent ratios of " very good" or " good" evaluations on the preparation before community postpartum family visits,general assessment of newborns in community postpartum family visits and the implementation of maternal physical examination in community postpartum family visits among the 18 community health service institutions were 86. 10%,85. 54%,and 86. 07% respectively,the constituent ratio of " very good" or " good" evaluations on the general assessment of delivery women in the visiting was 22. 25%;the average satisfaction rate of medical workers on the existing postpartum visiting conditions was 89. 86%,the average satisfaction rate of delivery women on the visiting time,frequency and contents of medical workers was 73. 20%. The score of nursing quality in community postpartum family visits of the 18 community health service institutions was between 65. 45 and 84. 13,with an average score of 70. 55 and a score span of 18. 68. Conclusion With scientific and comprehensive covering contents,the evaluation index system of nursing quality in community postpartum family visits has certain operational appropriateness and practical value. However,problems such as insufficient job training of the personnel,lack of specific examination and low satisfaction among delivery women are still exist.%目的 对"社区产后家庭访视护理质量评价指标体系"进行实证研究,以了解社区产后家庭访视护理服务开展情况及存在问题,为今后完善社区产后家庭访视护理质量评价提供实用性评估工具和理论依据.方法 于2016年10—12月,以3:1的比例在银川市3个市辖区中随机抽取社区卫生服务机构18家.根据"社区产后家庭访视护理质量评价指标体系",结合社区产后家庭访视护理工作现状,设计相应评价量表和调查问卷,由科研小组成员进行实地调查和考评.其中,过程质量评价采用 《社区产后家庭访视护理过程质量现场考察表》,结构质量、结果质量评价采用 《社区产后家庭访视护理服务定性及定量评价指标调查表》《社区产后家庭访视护理工作人员满意度调查问卷》《产妇满意度及相关健康知识知晓程度调查表》.调查数据经标准化转换后得到各指标的标准得分,然后采用加权累加综合评分法计算各社区卫生服务机构的社区产后家庭访视护理质量得分.结果 18家社区卫生服务机构中,社区产后访视人员中的医生数均为0、社区护士数均为1,访视人员年岗位培训率、年度理论和技能考核合格率均为0;对18家社区卫生服务机构社区产后访视前准备、社区产后访视中新生儿一般情况评估、社区产后访视中产妇体格检查的实施情况评价为非常好/好的构成比分别为86.10%、85.54%、86.07%,对访视中产妇一般情况评估的实施情况评价为非常好/好的构成比为22.25%;访视人员对现有产后访视条件的平均满意度为89.86%,产妇对访视人员访视时间/次数/内容的平均满意度为73.20%.18家社区卫生服务机构的社区产后家庭访视护理质量总得分为65.45~84.13分,平均分为70.55分,分值跨度为18.68分.结论 "社区产后家庭访视护理质量评价指标体系"覆盖内容较为科学、全面,具有一定的操作适宜性和实用价值;社区产后家庭访视工作还存在人员岗位培训不到位、专科检查欠缺、产妇满意度较低等问题.
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