提升無痛分娩待產婦女下床活動率

Promoting Getting-Out-of-Bed Activity for Expectant Mothers with Epidural Birth

產婦待產期間下床活動可促進產程進展、降低生產過程之合併症。本專案旨在提升單位無痛分娩待產婦女下床活動率，經現況分析後，發現因缺乏無痛分娩照護流程、無痛分娩護理指導工具、護理人員對無痛分娩照護認知不足及麻醉科鼓勵平躺，導致產婦對無痛分娩期間下床活動的答對率僅52.7%且下床活動率僅5.4%。經實施以下改善方案：與麻醉科醫師取得共識，制訂「無痛分娩照護標準流程」、製作「無痛分娩待產護理指導單張」與「無痛分娩照護檢核表」，規劃無痛分娩照護在職教育課程與關懷媽媽寶寶課程。無痛分娩待產婦女對無痛分娩期間下床活動之答對率提升至85.4%，下床活動率提升至66.7%，達專案目的。本專案的實施，確實提升無痛分娩待產婦女之下床活動率及增進其待產期間之醫療照護品質。

Getting-out-of-bed activity may promote expectant mothers' laboring progress and lower complications. This project aims at promoting getting-out-of-bed activity for expectant mothers with epidural birth. An analysis indicated that only 52.7% of expectant mothers with epidural birth responded correctly to survey questions regarding getting-out-of-bed activity, and only 5.4% got out of bed during labor. The affecting factors included lack of a caring protocol pertaining to epidural birth and patient educational tools, nurses' insufficient knowledge about epidural birth, and anesthesiologists' preference to keep expectant mothers with epidural birth in a supine position. After implementation of improvement measures, such as reaching a consensus with anesthesiologists, developing a standard procedure of epidural birth, designing educational leaflets of epidural birth and a checklist for epidural birth, and scheduling on-job in-service courses for epidural birth and courses for expectant mothers, the correct response rate on knowledge raised to 85.4% and the getting-out-of-bed activity rate raised to 66.7%. This project actually promoted getting-out-of-bed activity of expectant mothers and enhanced healthcare quality during their laboring period.