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Accreditation maternity and Obstetric Services (MOS), Based on the Accreditation Standards of the Joint Commission International (JCI)

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Health 2014年第18期6卷 2453-2460页

作者： Fereshteh Farzianpour Keramat Nourijelyani Hamed Zandiyan Telma Zahirian Moghadam Shima Zahirian Moghadam Department of Health Management & Economics School of Public Health Tehran University of Medical Sci-ences Tehran Iran Department of Epidemiology and Biostatistics School of Public Health Tehran University of Medical Sciences Tehran Iran Health Policy Hospital Management Research Center University of Medical Sciences Tehran Iran Health Care Management Department of Health Management and Economics School of Public Health Tehran University of Medical Sciences Tehran Iran Health Management and Economics Research Center Iran University of Medical Science Tehran Iran

Background: In recent years various standards have been proposed for assessment and supervision of healthcare systems. One of the most popular of them in health care area is Joint Commission International (JCI) standards of US. This study has been conducted to investigate executive potentials related Accreditation Standards of maternity and birth services of this commission in hospitals providing maternity and birth services in Ardebil Province. Methods: This is a descriptive-analytic study conducted as cross-sectional on 232 employees of three hospitals in Ardebil including Alavi, Arta and Sabalan who were randomly chosen. This is a multi-stage study that in stage 1, an accreditation tool for maternity and birth services was designed based on JCI standards. Validity and reliability of questionnaire was measured by Alpha Cronbach. In stage 2, score of different dimension of Accreditation Standards of MOS was calculated using data obtained from questionnaires distributed among a sample of 232 hospitals personnel;all of them were working in maternity and birth field. Statistical tests used are one-way analysis of variance (ANOVA), dunnets post hoc and correlation test that all of them were calculated by SPSS V. 18. Results: Result showed that all of the MOS accreditation standards components were capable in selected hospitals. Arta hospital earned the highest score of standards (mean = 149/4) and Alavi hospital received the lowest score (mean = 128/04) of the maximum attainable score (186). Also, significant difference was observed between selected hospitals in total score of MOS standards (F = 50/432, p < 0/00). Conclusion: Based on study findings, there is an inequality between Ardebils hospital in field of MOS accreditation standards. Public hospitals are in more difficult situation compared to private hospitals, therefore Health Care System policy makers must pay attention systematically and specially to implementation of international standards in order to improv

关键词： Accreditation JCI Standards maternity and Obstetrics Service Selected Hospitals

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Morbidity and Mortality Related to Obstetrical Evacuations in a Country with Limited Resources: The Case of the maternity Ward of the Prefectural Hospital of Coyah, Guinea

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Open Journal of Obstetrics and Gynecology 2021年第9期11卷 1140-1150页

作者： Mamadou Hady Diallo Ibrahima Sory Baldé Fatoumata Bamba Diallo Alpha Boubacar Barry Massa Keita Emile Tinguiano Telly Sy Namory Keita University Department of Gynecology-Obstetrics Donka National Hospital Conakry Guinea University Department of Gynecology-Obstetrics Ignace Deen National Hospital Conakry Guinea maternity Ward of the Prefectural Hospital of Coyah Coyah Guinea

Obstetric complications requiring evacuation are found all over the world with a high frequency in developing countries where they are responsible for high fetal-maternal morbidity and mortality. The objectives of this study were to calculate the frequency of obstetric evacuations in the maternity ward of the Coyah prefectural hospital, describe the socio-demographic characteristics of the evacuated patients, identify the main reasons for evacuation, determine the means of transport used and specify the maternal and fetal prognosis. Patients and Method: This was a prospective descriptive and analytical study conducted over a 6-month period (April 1-September 30, 2020) at the maternity ward of the Coyah prefectural hospital. All patients evacuated for complications of gravidopuerperium were included in the study. Results: We recorded 84 cases of obstetric evacuations out of a total of 2206 consultations, i.e. a frequency of 3.8%. The average age of the patients was 25.22 years with extremes of 15 and 45. Housewives (58.82%), nulliparous women (36.93%) and women with no education (64.29%) were the most numerous ones. No patient received medical transportation. More than half of the patients were evacuated by a nurse (51.21%). Hemorrhage in the last quarter was the main reason for evacuation. The average distance traveled by patients was 18.3 km with extremes of 12 and 68 km. The average transfer time was 63 min (1 h 3 minutes) with extremes of 20 min and 300 min (5 h). Maternal mortality was 5.95%. The perinatal mortality rate was 46.42%. No counter-referral was made. Conclusion:

关键词： Morbidity Mortality Obstetrical Evacuations maternity Guinea

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Hospital Hygiene maternity Hospital Public Lubumbashi Democratic Republic of Congo

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Open Journal of Preventive Medicine 2017年第4期7卷 74-85页

作者： Kaj Francoise Malonga Hendrick Lukuke Mbutshu Jean-Jacques Lunda Ngandu Mukengeshayi Abel Ntambue Michel Makoutode School of Public Health University of LubumbashiLubumbashiDR Congo Regional Institute of Public Health OuidahBenin Republic

Introduction: Public hospitals in the DRC are of significant disrepair, while there is a strong link between the failure of hospital hygiene and the incidence of nosocomial infections. We have conducted a study with the objective of evaluating the structural-functional conditions of hospital hygiene maternity wards of public hospitals in Lubumbashi. Methodology: It was a descriptive cross-sectional study and structural-functionalist whose population consisted of nurses responsible for 7 of 12 maternity hospitals which were selected based on the inclusion criteria. The observation with an observation guide and maintenance using a questionnaire we used to collect data. Results: The results showed that hospital hygiene conditions in maternity wards of public hospitals in Lubumbashi are not good because almost all maternity services and surgery are not always water in the taps (14.3%). The bins were a means for care units, no coding system exists to distinguish the type of waste. The medical waste are mixed and the other waste are burned in the open or in makeshift incinerator with other types of waste. Conclusion: These maternity wards have poor hygiene, staff responsible for this sector did not follow any training in this area. There is need to regulate the sector and train them.

关键词： Hospital Hygiene maternity Hospital Waste Management

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Practices of maternity’s Care Providers in the Municipality of Kozah 1 Regarding the Administration of Vitamin K1, Eye Care, and Umbilical Cord Care in Immediate Postpartum Newborns

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Open Journal of Pediatrics 2023年第4期13卷 484-495页

作者： Ouro-Bagna Tchagbele Kokou Agbékogni Réné Segbedji Missoki Azanledji Boume Sollim Myriam Talboussouma Kadji Kombieni Fidèle Comlan Dossou Alouki Essossinam Constantine Adom Flore Djath Palabié Lare Pouhawè Zato Koffi Edem Djadou Adama Dodzi Gbadoe Komi Deladem Azoumah Pediatrics Department University of Kara Kara Togo Surgical Department and Specialities University of Kara Kara Togo National School of Midwifery Kara Togo Pediatrics Department University of Lomé Lomé Togo

Background: Neonatal mortality is a real public health problem in the world and particularly in countries with limited resources. Essential care remains an effective means of reducing this mortality. Objective: To evaluate the practice of administering of vitamin K1, ocular and cord care in maternity wards in the Kozah 1 municipality. Method: This is a cross-sectional study conducted from March 1st to June 30th, 2022 in all maternity wards in the Kozah 1 municipality. Socioprofessional aspects of providers and those related to the administration of vitamin K1, ocular and cord care were studied. Results: Eighty-five (85) maternity providers were included in this study. The average age of the providers was 36.2 years with extremes of 21 and 55 years. Providers were midwives (51.8%), childbirth attendants (35.3%), and matrons (12.9%). The average length of practice was 9.5 years with extremes of 1 and 28 years. For three out of four providers (75.3%), the postpartum period was defined as a period of 02 hours following delivery. The importance of cord, ocular care, and administration of vitamin K1 in postpartum was known respectively by 84.7%, 98.8%, and 92.9% of the providers. Chlorhexidine gel was used by 81.2% of providers for umbilical cord care. For ocular disinfection, more than half of the providers (52.9%) reported using half-diluted povidone iodine. No center had displayed care protocol. Conclusion: This study highlighted the level of knowledge and practice of three essential postpartum care practices. The products used for the different care practices are consistent with recommendations but vary according to the care providers.

关键词： Essential Care Newborn Immediate Postpartum maternity Togo

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Problematic of Clandestine Induced Abortions in Three maternity Hospitals of Chad

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Open Journal of Obstetrics and Gynecology 2017年第9期7卷 937-943页

作者： Lhagadang Foumsou Guira Daniel Dangar Ouchémi Choua Sadjoli Damthéou Bray Madoué Gabkika Olivier Moalloum Tarda Rostand Dounou Njiki Department of Gynecology and Obstetrics University of N’Djamena N’Djamena Chad N’Djamena Mother and Child Hospital N’Djamena Chad Department of Surgery University of N’Djamena N’Djamena Chad UNFPA City Chad

Background: In the world, induced abortion constitutes a preponderant cause of morbidity and maternal mortality, more particularly in developing countries. In these countries, the prevalence of contraception remains low, and situation makes the bed of unwanted pregnancies leading easily to the induced abortions. The objective was to determine frequency of clandestine induced abortions and to know the motivations of women that practice these abortions in order to find a solution to minimize this practice. Patients and method: We conducted a prospective, descriptive and multicenter survey for three months from November 1st, 2015 to January 31st, 2016 achieved at N’Djamena Mother and Child hospital which is national reference structure in terms reproduction health, Moundou Regional Hospital and Abéché Regional Hospital about the epidemiological aspects and complications clandestine induced abortions. The population of survey was constituted of patients admitted in a maternity of these hospitals for clandestine induced abortion. Every patient having practiced a documented induced abortion and having agreed to participate in the survey was included. Results: During the survey period, we recorded 94 cases of clandestine induced abortions among 2759 deliveries giving a frequency of 3.4%. The age group between 20 - 24 years was the most represented with 42.7%. The average age was 25.4 years, with the extremes ranging from 15 to 42 years. Singles (66%) dominated marital status. Sixty patients (63.9%) were of secondary. These patients were for the most part students or pupils (55.3%). Concerning the parity, nulliparous were the most numerous to practice the abortion (40.5%). More than half our patients (58.7%) knew no contraceptive method. The principal reason evoked to realize the abortion was further studies (38.2%). Means of abortion most used was the misoprostol (36 cases that is 38.2%). In this series, we observed 29 cases of complications, which is 30.8%. The complicati

关键词： Clandestine Induced Abortion Motivations Complications maternity Chad

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Evidence of Linkages between Patient Safety and Person-Centred Care in the maternity and Obstetric Context—An Integrative Review

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Open Journal of Nursing 2017年第3期7卷 378-398页

作者： Elisabeth Severinsson Megumi Haruna Maria Ronnerhag Anne Lise Holm Britt S.Hansen Ingela Berggren Centre for Women’s Family&Child HealthDepartment of Nursing and Health SciencesFaculty of Health and Social SciencesUniversity College of Southeast-NorwayKongsbergNorway Department of Midwifery and Women’s Health Division of Health Sciences&NursingGraduate School of MedicineThe University of TokyoTokyoJapan Department of Health Sciences University WestTrollhattanSweden Department of Health Sciences Western Norway University of Applied SciencesHaugesundNorway Department of Health Studies Faculty of Social SciencesUniversity of StavangerStavangerNorway

The aim was to evaluate the current state of knowledge pertaining to patient safety and its link to person-centred care. The international relevance of patient safety has expanded, as have the models of person-centred care. Inspired by this new trend, we collated and summarized the literature for evidence of the two topics. The study was guided by Russell, Whittemore and Knafl’s integrative review framework. An electronic database search was conducted for relevant articles from 2005 to 2016. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The structure and process of the evaluation of the evidence are described and the findings interpreted by means of a thematic synthesis. One theme emerged: trustful, safe communication in the relationship between the patient, family members and healthcare professionals and two domains;safety culture and multidisciplinary capacity building. The dominant dimension in the safety culture domain is respectful communication, which implies sharing experiences that lead to a sense of control during labour and birth and is related to the women’s feeling of personal capacity. The dominant dimensions in the multidisciplinary capacity building domain are collaborative teamwork, coordination and risk management, knowledge sharing and patient-centred communication. In conclusion, to enhance patient safety, it is necessary to develop patient-focused, evidence-based skills and guidelines as well as a supportive organization. Due to their interaction with patients, midwives’ communication competence on the part of midwives is essential for supporting the birth and fulfilling the women’s needs and expectations.

关键词： Communication Integrative Review Midwifery Nursing Patient Safety Person-Centred Care maternity Obstetric Care

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Contribution of safe motherhood solidarity groups in using and accessing maternity services during a period of armed conflict

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Health 2013年第7期5卷 1085-1091页

作者： Richard Bitwe Mihanda Jean Robert Likofata Gwendolyn J. Lusi Development Projects HEAL Africa Goma DR Congo Mentor Research Hospital Management HEAL Africa Goma DR Congo

This report presents the results of a study on Reproductive Health done in North Kivu in September 2009. It was conducted by HEAL Africa, in partnership with the Provisional Division of Health, and financed by the University of Ottawa, Canada/CRDI with technical assistance from Western Cape University of South Africa. The study was conducted in the health zones of Birambizo and Kayna within the framework of the central office. The focus of the report is on one aspect of Reproductive Health—Low Risk maternity. This study was conducted in rural areas given that Reproductive Health indicators are much weaker when compared with urban areas, according to EDS RDC, 2007 [1]. This study emphasizes the following points: General characteristics of the participants in the study, and the utilization and accessibility of maternity services in rural areas in conflict situations. The formula SPSS 12.0.1 was used to facilitate data analysis in the study. This study comes at a point in time when its relevance to HEAL Africa’s work will assist HEAL and its partners in determining the focus of interventions done in health zones in order to improve maternal and neonatal health. HEAL Africa firstly stepped into a Safe Motherhood pilot project in June 2006 for 9 months in the Masisi zone, then in 2007 in the Birambizo and Kayna health zones. In November 2007, HEAL expanded into Walikale and in October 2008, into Kirotshe, Binza, and Lubero. The intervention kit consists of reinforcing the capacity of existing health facilities, training traditional midwives who serve as a link between the community and the health structures, the provision of sanitary equipment, medical essentials and community mobilization was done through local leaders about health and reproduction, and organizing women of reproductive age in solidarity groups (SG) to generate maternity insurance. The community approach “Solidarity Groups for maternity Insurance” constitutes the spine of HEAL Africa within the support i

关键词： Safe Motherhood Solidarity Group Usage of maternity Services Accessibility of maternity Services Reproductive Health Maternal Health

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Attitude toward Safety among Staffs in the Iranian maternity Care Units of Public Hospitals with High Maternal Death Rate, 2015-2016

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Open Journal of Obstetrics and Gynecology 2017年第3期7卷 386-394页

作者： Nahid Akbari Marzieh Malek Shima Haghani Midwifery and Reproductive Health School of Nursing and Midwifery Iran University of Medical Sciences Tehran Iran School of Nursing and Midwifery Iran University of Medical Sciences Tehran Iran Department of Biostatistics School of Management and Information Technology Iran University of Medical Sciences Tehran Iran

Background: Although extensive Mother-friendly Hospital initiatives have been improved the quality of maternity care in Iran, recent national reports have been indicated that obstetrics errors are still common. The current study aimed to assess safety attitude in the maternity care units of public hospitals in a region with high rate of maternal death in Iran. Materials and Methods: Data was collected from 314 midwives, specialist and also managers working in all public hospitals in 2016. The Cronbach’s alpha coefficient was used to analyze psychometric features of the Safety Attitudes Questionnaire (SAQ). Results: 86.2% of the participants (n = 314) completed the questionnaire. Results showed that lower scores in teamwork, safety climate and also job satisfaction subcomponents. The working conditions and stress recognition had the highest negative scores. There was a significant relationship between the following subcomponents and work load: teamwork (r = ﹣0.416, P-value = 0.05), stress recognition (r = 0.40, P-value = 0.05) and also working conditions (r = 0.421;P-value = 0.02). The score of midwives was significantly lower than specialists regarding job satisfaction (P-value = 0.014), working conditions (P-value = 0.02) and also the overall safety attitude score (P-value = 0.001). About 63% of respondents reported no error during the last year. The mean of error reporting during the last year significantly increased among specialists compared to midwives (P-value = 0.001). Conclusion: maternity care units in the region with high maternal death have been faced with many intangible barriers related to safety attitude such as poor teamwork climate, working condition and also poor stress recognition. It is now needed to promote supportive environment for midwives and also strengthening staff cohesion through guiding the strategic direction of current maternity risk management system in creating open and just culture, improving leadership behaviors among senior manage

关键词： Safety Attitude maternity Care Quality Care Safety Culture Risk Management

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Women's awareness of the role of midwifes and their preference for health professionals for maternity care: a systematic review

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Nursing Communications 2022年第1期6卷 156-160页

作者： Malak Yousef Bughdadi Afnan AALbokhary Faculty of Nursing Department of Midwifery PracticeUmm Al-Qura UniversityAlabdeyah Makkah 24351Saudi Arabia Ministry Of Health Kingdom of Saudi ArabiaAsshawqiya 8003MakkahSaudi Arabia.

Objective:Several studies have shown that women are more satisfied with midwife-led ***,their awareness regarding the midwives’roles was *** effect of the women’s awareness on their preferences for maternity care from health professionals has not been *** identify research findings presenting women’s awareness of midwives’roles and preferences for receiving maternity care from health ***:The systematic literature review used various electronic search engines,including SCOPUS,PubMed,ScienceDirect,and Cochrane ***,other grey literature sources,including Google Scholar,were utilized to identify *** search included only English language articles published between ***:This search provided 20 studies that fulfil the inclusion criteria and are relevant to the Population,Intervention,Comparison,and Outcomes *** knowledge of midwives’role among the public is well studied in the literature,and few papers(4 studies)focused on women’s *** review of existing literature indicated the midwifery workforce in Arab countries like Saudi Arabia,the impact of midwives’role on maternal and child health outcomes,women’s experiences regarding midwife-led care,women’s knowledge and perception regarding the role of the midwife in maternal care,and the womens’preference for midwifes’role within the range of maternal care ***:The review found a lack of awareness and knowledge among the public about the midwife’s role,particularly among *** to evidence,women’s preferences for choosing health professionals for maternity care primarily depend on being informed about their care,being given care options,and the health professionals’comprehension of their particular care needs.

关键词： Saudi Arabia midwives midwifery maternal maternity child midwives’roles and competencies midwife-led care

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Maternal Complications of Caesarean Section in a Resource-Limited Country: The Case of the maternity Unit of Kankan Regional Hospital, Guinea

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Open Journal of Obstetrics and Gynecology 2019年第7期9卷 981-990页

作者： Mamadou Hady Diallo Ibrahima Sory Baldé Amadou Diouldé Diallo Ousmane Baldé Boubacar Siddi Diallo Ibrahima Sylla Oumou Hawa Bah Lanciné Doumbouya Aisssatou Taran Diallo Yolande Hyjazi Namory Keita University Department of Gynecology-Obstetrics Donka National Hospital Conakry Guinea University Department of Gynecology-Obstetrics Ignace Deen National Hospital Conakry Guinea University Department of Visceral Surgery Donka National Hospital Conakry Guinea maternity Unit Kankan Regional Hospital Kankan Guinea University Department of Visceral Surgery Ignace Deen National Hospital Conakry Guinea

Introduction: Innovations in surgical and anaesthetic techniques to provide a good maternal and child safety have made the cesarean section a routine intervention in obstetrics. However, its complications, especially the short or long term per and postoperative maternal ones, are not exceptional and can affect mothers’ vital prognosis. The objectives of this study were to describe the maternal per and postoperative complications encountered during the cesarean section. Patients and method: This is a prospective, descriptive and analytical study carried out at the maternity ward of Kankan Regional Hospital over a 6 month period from January 1, 2018 to June 30, 2018. Results: During this period, out of a total of 2229 deliveries, 319 caesarean sections were performed i.e. a rate of 12.51%. Complications concerned 111 patients (34.79%). The average age was 28 with extremes of 15 and 45. Non-medical transportation concerned 71.17% of our patients. The cesarean section was performed in emergency situations in 82.8% of cases. Indications were dominated by the fetopelvic disproportion. There was a statistically significant relationship between labour duration and the occurrence of complications. Intraoperative complications were dominated by bleeding (25.22% of all complications and 8.77% of total cesarean sections). Post-operative complications were dominated by parietal suppurations (94.49% of all complications and 34.79% of the total number of cesarean sections). In most cases, patients simultaneously developed several complications. Conclusion: The maternal complications of cesarean sections remain considerable. If the increase in the rate of caesarean sections has contributed to the improvement of the mother-fetal prognosis, the surgical procedure itself is not without complications, which encourages us to review its indications for a better management. Hemorrhagic and infectious complications were the most frequent. These results call for increased asepsis measures i

关键词： Complications Cesarean maternity Kankan-Guinea

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