scholarly journals Patient-Centred Care in Maternity Services

Author(s):  
Claire de Labrusse ◽  
Anne Sylvie Ramelet ◽  
Tracy Humphrey ◽  
Sara MacLennan
2020 ◽  
Author(s):  
Paulo Das Das Neves Pires ◽  
Martins Mupueleque ◽  
Jaibo Mucufo ◽  
Ronald Siemens ◽  
Celso Belo

Abstract BackgroundMaternity service quality is essential to reduce maternal and new-born morbidity and mortality (extremely high in Africa, including Mozambique). In Mozambique, maternal mortality rate is 451.6 maternal deaths per 100000 live births (2017). The reasons for this are complex, but one important factor to reduce this burden is ensuring the quality of maternity services, with the availability of efficient care, to improve institutional deliveries. To contribute to reduce maternal and new-born mortality rates in Natikiri, Nampula, the Lúrio University and the University of Saskatchewan, carried out an implementation research, including training activities for health professionals in maternal and child health care. We planned a mid-project evaluation, to assess the impact of the trainings, on the quality of services at Marrere Hospital Maternity.MethodsQuantitative pre-post study, applying two cross-sectional surveys about maternity service quality, one of the surveys being conducted after five health professionals’ trainings and the other after six more trainings. The two surveys included samples of post-partum women in the maternity, calculated with a 10% margin error and 90% confidence interval for the first survey, and with a 7% margin error and 95% confidence interval for the second. The surveys were entered into REDCap and analysed to assess frequency, percentage, mean and standard deviation. This research was approved by the Institutional Committees of Bioethics at Lúrio University and at the University of Saskatchewan.Results116 post-partum women were surveyed at the maternity, assessing standards of patient centred care during delivery labour. Most areas showed no improvement. Some positive improvements were: delivering women were given the option to have a person of their choice to accompany them during labour (75%), notably a traditional birth attendant (34%), and they had continuous support from an health professional (68%). But many shortcomings persisted in areas of privacy (33%), and confidentiality (57%). ConclusionThe quality of patient centred care at Marrere General Hospital Maternity, did not improve with health professionals training. Decreasing the large turnover rate, and reviewing health professionals learning styles, promoting continuous professional capacity building, would be the next steps to improve quality of patient centred care.Trial registrationThis study was not registered in any data base.


2018 ◽  
Vol 28 (2) ◽  
pp. 561-565
Author(s):  
Radost Assenova ◽  
Levena Kireva ◽  
Gergana Foreva

Background: Patients with multimorbidity represent a significant portion of the primary healthcare population. For healthcare providers, managing patients with multiple chronic conditions represents a challenge given the complexity and the intensity of interventions. Integrated and patient-centered care is considered an effective response to the needs of people who suffer from multiple chronic conditions. According to the literature providing patient-centered care is one of the most important interventions in terms of positive health-related outcomes for patients with multimorbidity.Aim: The aim of the study is to evaluate the GPs’ perception of patient oriented interventions as key elements of patient centred care for patients with multimorbidity.Material and methods: A cross-sectional pilot study was conducted among randomly selected 73 GPs. A direct individual anonymous survey was performed to explore the opinion of respondents about the importance of two patient-oriented interventions, each one including specific elements of patient-centered care for patients with multimorbidity. The tool was developed as a result of the scoping review performed by Smith et al. (2012;2016). A 5-point Likert scale (0-not at all, 1-little, 2-rather, 3-much, 4-very strong) was used. The data were analysed using descriptive statistics. In processing the data, the software product for statistical analyses - SPSS version 17 was performed for Windows XP.Results: Our results show that both categories - providing patient-oriented approach and self-management support interventions were highly accessed by the respondents. The most frequent categories of interventions identified in our study were Creating individualized and adapted interventions, Performing regular contacts and Reinforcing adherence. Less frequently reported elements such as Considering relatives’ needs and Developing self-management plan are still underestimated by the Bulgarian GPs.Conclusions: The acceptance and understanding of innovative patient-centered interventions adapted to patients with multimorbidity could be accepted as a good indicator for improving health-related outcomes and care for patients with multiple chronic conditions.


Author(s):  
Graham Brack ◽  
Penny Franklin ◽  
Jill Caldwell

Medicines Management for Nursing Practice: Pharmacology, Patient Safety, and Procedures is a friendly guide designed to equip pre-registration and newly qualified nurses with the medicines management knowledge and skills to provide safe patient-centred care. Balancing theory with practical advice, this accessible text covers basic pharmacology, drug calculations, key legislation and standards, and patient safety. Drawing from the most up-to-date sources of evidence and advice, including NMC and BNF guidelines, Medicines Management for Nursing Practice prepares nurses to promote their patients' safety, concordance, understanding of medicines, and wellbeing. This book takes a lively and straightforward approach to a vital set of nursing skills. Learning features such as reflection points, exercises, and further reading help readers to develop and consolidate their knowledge. Chapters on pharmacology and drug calculations take a step-by-step approach and are supported by diagrams and examples to aid understanding. Case studies relate guidelines and theories to the common practical scenarios that nurses encounter on a day-to-day basis.


1991 ◽  
Vol 98 (11) ◽  
pp. 1073-1078 ◽  
Author(s):  
C. M. PATERSON ◽  
J. C. CHAPPLE ◽  
R. W. BEARD FRCOG ◽  
MICHAEL JOFFE ◽  
P. J. STEER ◽  
...  

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Walusa Assad Gonçalves-Ferri ◽  
◽  
Fábia Martins Pereira-Cellini ◽  
Kelly Coca ◽  
Davi Casale Aragon ◽  
...  

Abstract Background The World Health Organization recognizes exclusive breastfeeding a safe source of nutrition available for children in most humanitarian emergencies, as in the current pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Despite the Brazilian national guideline protecting breastfeeding practices, there are many concerns about protecting infants from their infected mothers. This study aimed to analyze how the Brazilian hospitals and maternity services promote and support mothers suspected or diagnosed with coronavirus disease (COVID-19). Methods This is a descriptive cross-sectional and multicenter study which collected data from 24 Brazilian hospitals and maternity services between March and July 2020. Representatives of the institutions completed a questionnaire based on acts to promote and support breastfeeding, the Baby-Friendly Hospital Initiative, and Brazil’s federal law recommendations. Results The results showed that in delivery rooms, 98.5% of the services prohibited immediate and uninterrupted skin-to-skin contact between mothers and their infants and did not support mothers to initiate breastfeeding in the first hour. On the postnatal ward, 98.5% of the services allowed breastfeeding while implementing respiratory hygiene practices to prevent transmission of COVID-19. Companions for mothers were forbidden in 83.3% of the hospitals. Hospital discharge was mostly between 24 and 28 h (79.1%); discharge guidelines were not individualized. Additionally, a lack of support was noticed from the home environment’s health community network (83.3%). Hospital and home breast pumping were allowed (87.5%), but breast milk donation was not accepted (95.8%). There was a lack of guidance regarding the use of infant comforting strategies. Guidelines specific for vulnerable populations were not covered in the material evaluated. Conclusions In Brazil, hospitals have not followed recommendations to protect, promote, and support breastfeeding during the COVID-19 outbreak. The disagreement between international guidelines has been a major issue. The absence of recommendations on breastfeeding support during the pandemic led to difficulties in developing standards among hospitals in different regions of Brazil and other countries worldwide. The scientific community needs to discuss how to improve maternal and infant care services to protect breastfeeding in the current pandemic.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eva S. van den Ende ◽  
◽  
Bo Schouten ◽  
Marjolein N. T. Kremers ◽  
Tim Cooksley ◽  
...  

Abstract Background Truly patient-centred care needs to be aligned with what patients consider important, and is highly desirable in the first 24 h of an acute admission, as many decisions are made during this period. However, there is limited knowledge on what matters most to patients in this phase of their hospital stay. The objective of this study was to identify what mattered most to patients in acute care and to assess the patient perspective as to whether their treating doctors were aware of this. Methods This was a large-scale, qualitative, flash mob study, conducted simultaneously in sixty-six hospitals in seven countries, starting November 14th 2018, ending 50 h later. One thousand eight hundred fifty adults in the first 24 h of an acute medical admission were interviewed on what mattered most to them, why this mattered and whether they felt the treating doctor was aware of this. Results The most reported answers to “what matters most (and why)?” were ‘getting better or being in good health’ (why: to be with family/friends or pick-up life again), ‘getting home’ (why: more comfortable at home or to take care of someone) and ‘having a diagnosis’ (why: to feel less anxious or insecure). Of all patients, 51.9% felt the treating doctor did not know what mattered most to them. Conclusions The priorities for acutely admitted patients were ostensibly disease- and care-oriented and thus in line with the hospitals’ own priorities. However, answers to why these were important were diverse, more personal, and often related to psychological well-being and relations. A large group of patients felt their treating doctor did not know what mattered most to them. Explicitly asking patients what is important and why, could help healthcare professionals to get to know the person behind the patient, which is essential in delivering patient-centred care. Trial registration NTR (Netherlands Trial Register) NTR7538.


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