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目的研究教练式培训在新生儿早期基本保健技术推广中的应用及效果,为今后临床开展各项培训提供新的方法和思路。方法在北京、陕西省和四川省各选择1所省级医疗保健机构和1所地市级医疗保健机构作为试点单位,医务人员接受2d教练式培训,比较研究对象培训前后新生儿保健理论知识的得分、洗手情况以及对于出生时有自主呼吸和无自主呼吸新生儿临床操作技能的得分情况。培训3个月后,每个试点医院随机抽样10名产妇进行出院前访谈,分析干预后各项新生儿保健措施的实施情况。结果培训后医务人员的理论知识得分(16.82±1.00)较培训前显著提高(11.90±2.68)(P<0.001)。三省及总体培训后洗手操作技能均提高,手部清洁程度显著改善(P<0.001)。培训后有呼吸和无呼吸新生儿操作技能得分中位数分别为41分和58分。培训3个月后,87%(52/60)的产妇分娩后进行了母婴皮肤接触,分娩后1min内开始母婴皮肤接触率为55%(33/60),皮肤接触持续90min的占47%(28/60);出院前母乳喂养率达到77%(46/60),纯母乳喂养率为48%(29/60)。结论新生儿早期基本保健技术的教练式培训方法效果较好,培训后医务人员能迅速掌握正确的操作技能,有利于促进新技术在临床上的推广和使用。
Objective To study the application and effect of coaching training in the promotion of newborn basic health care technology and to provide new methods and ideas for clinical training in the future. Methods A total of 1 provincial-level healthcare institutions and 1 municipal-level healthcare institutions were selected as the pilot units in Beijing, Shaanxi Province and Sichuan Province. The medical staff received 2-d coaching training and compared the theoretical knowledge of neonatal care before and after training Scoring, hand-washing conditions, and scores on the clinical skills of newborns with spontaneous breathing and spontaneous breathing at birth. After training for 3 months, each pilot hospital randomly sampled 10 mothers to conduct pre-discharge interviews and analyzed the implementation of various neonatal health measures after intervention. Results The score of theoretical knowledge of medical staff after training (16.82 ± 1.00) was significantly higher than that before training (11.90 ± 2.68) (P <0.001). The skills of hands-washing operation in all three provinces and the overall training were improved and the hand-cleanliness was significantly improved (P <0.001). After training, breathing and non-breathing neonatal skills were the median score of 41 points and 58 points. Three months after training, 87% (52/60) of mothers gave birth to mother and baby skin after childbirth. The rate of mother-to-child skin contact was 55% (33/60) within 1 minute after childbirth and 47% for skin contact lasting 90 minutes % (28/60). The rate of breastfeeding before discharge was 77% (46/60) and that of exclusively breastfeeding was 48% (29/60). Conclusion The coaching training method of early neonatal basic health care technology is effective. After training, medical staff can quickly grasp the correct operating skills and help to promote the clinical application and promotion of new technologies.