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Register a new userAssessment of midwives' s knowledge about strategies used in the prevention and management of postpartum hemorrhage
تقييم معلومات القابلات حول الاستراتيجيات المستخدمة في الوقاية و تدبير النزيف بعد الولادة
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Tishreen University ورقة بحثية
Publication date
2016
fields
Nursing
and research's language is
العربية
Authors
نسرين محيي مصطفى( باحث )
Created by
Shamra Editor
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يعد النزيف بعد الولادة (PPH- (Postpartum Hemorrhage أحد أهم المضاعفات التي تحدث بعد الولادة الطبيعية أو القيصرية, و يمثل حوالي ربع وفيات الأمهات حول العالم. و تلعب القابلات الدور الأساس في الوقاية من النزيف بعد الولادة. لذا يهدف هذا البحث إلى تقييم معلومات القابلات حول الاستراتيجيات المستخدمة في الوقاية من النزيف بعد الولادة و تدبيره. حيث شملت عينة البحث جميع القابلات الموجودات في قسم التوليد في مشفى الأسد الجامعي و مشفى الأطفال و التوليد و مشفى تشرين الجامعي في مدينة اللاذقية. و جمعت البيانات باستخدام استمارة استبيان مطورة من قبل الباحث. و قد أظهرت النتائج أن مستوى المعرفة فيما يتعلق بالاستراتيجيات المستخدمة في الوقاية و تدبير النزيف بعد الولادة عند (60 %) من القابلات كان "غير ملائم". و بينت وجود علاقة عكسية هامة إحصائياً (P=0.006) بين عمر القابلات و مستوى المعرفة لديهن. و علاقة عكسية هامة إحصائياً أيضاً بين عدد سنوات الخبرة لدى القابلات و مستوى المعرفة لديهن (P=0.01). لذلك نقترح إجراء دورات تدريبية و محاضرات تثقيفية للقابلات فيما يتعلق بالاستراتيجيات المستخدمة في الوقاية من النزيف بعد الولادة و تدبيره، و ضرورة تقييم معلومات القابلات حول الوقاية و تدبير النزيف بعد الولادة بشكل دوري و مستمر.
The bleeding after delivery (Postpartum Hemorrhage-PPH) is the most important complications that occur after a natural or cesarean delivery, and represents about a quarter of maternal mortality around the world. Midwives play a basis role in prevention of bleeding after birth. So This research aims to evaluate the knowledge of midwives about using strategies to prevention and management the bleeding after delivery. Its sample included all midwives in obstetrics departments in Alasad University, Children and Obstetric, and Tishreen University Hospital all in Lattakia city. Data were collected using a questionnaire developed by researcher. The results according to strategies used in prevention and management of bleeding after delivery showed that 60% of the level of knowledge of midwives were "inappropriate". There were significant inverse relationship (P = 0.006) between ages of midwives and level of knowledge. Also showed a significant inverse relationship between number of years of experience with the midwives and level of knowledge (P = 0.01). So we suggest conducting training sessions and educational lectures for midwives with respect to the strategies used in prevention and management of bleeding after delivery, and must evaluate the midwives information about prevention and management of bleeding after delivery periodically and continuously.
Artificial intelligence review:
Research summary
تعد مشكلة النزيف بعد الولادة (PPH) من أخطر المضاعفات التي تواجه النساء بعد الولادة الطبيعية أو القيصرية، حيث تمثل حوالي ربع وفيات الأمهات حول العالم. تلعب القابلات دورًا حاسمًا في الوقاية من هذا النزيف وإدارته. يهدف هذا البحث إلى تقييم مستوى معرفة القابلات بالاستراتيجيات المستخدمة في الوقاية من النزيف بعد الولادة وتدبيره. شملت الدراسة جميع القابلات العاملات في أقسام التوليد في مشفى الأسد الجامعي، مشفى الأطفال والتوليد، ومشفى تشرين الجامعي في مدينة اللاذقية. تم جمع البيانات باستخدام استبيان مطور من قبل الباحثة. أظهرت النتائج أن 60% من القابلات لديهن مستوى معرفة غير ملائم بالاستراتيجيات المستخدمة في الوقاية وتدبير النزيف بعد الولادة. كما بينت الدراسة وجود علاقة عكسية هامة إحصائيًا بين عمر القابلات ومستوى معرفتهن، وكذلك بين عدد سنوات الخبرة ومستوى المعرفة. بناءً على هذه النتائج، توصي الدراسة بإجراء دورات تدريبية ومحاضرات تثقيفية للقابلات بشكل دوري ومستمر لتحديث معلوماتهن حول الاستراتيجيات المستخدمة في الوقاية وتدبير النزيف بعد الولادة.
Critical review
دراسة نقدية: على الرغم من أهمية البحث في تسليط الضوء على دور القابلات في الوقاية وتدبير النزيف بعد الولادة، إلا أن هناك بعض النقاط التي يمكن تحسينها. أولاً، كان من الأفضل تضمين عينات من مشافٍ أخرى في مناطق مختلفة للحصول على نتائج أكثر شمولية. ثانياً، لم يتم التطرق بشكل كافٍ إلى العوامل الثقافية والاجتماعية التي قد تؤثر على مستوى معرفة القابلات. ثالثاً، كان من الممكن استخدام أدوات تقييم أكثر تنوعًا وشمولية لضمان دقة النتائج. وأخيرًا، كان من الأفضل تقديم توصيات أكثر تفصيلية حول كيفية تنفيذ الدورات التدريبية والمحاضرات التثقيفية بشكل فعال.
Questions related to the research
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ما هو الهدف الرئيسي من البحث؟
الهدف الرئيسي من البحث هو تقييم مستوى معرفة القابلات بالاستراتيجيات المستخدمة في الوقاية من النزيف بعد الولادة وتدبيره.
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ما هي نسبة القابلات اللاتي لديهن مستوى معرفة غير ملائم بالاستراتيجيات المستخدمة في الوقاية وتدبير النزيف بعد الولادة؟
نسبة القابلات اللاتي لديهن مستوى معرفة غير ملائم بالاستراتيجيات المستخدمة في الوقاية وتدبير النزيف بعد الولادة هي 60%.
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ما هي العلاقة بين عمر القابلات ومستوى معرفتهن؟
هناك علاقة عكسية هامة إحصائيًا بين عمر القابلات ومستوى معرفتهن، حيث كلما ازداد عمر القابلة تناقصت نسبة المعرفة الملائمة.
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ما هي التوصيات التي قدمتها الدراسة بناءً على النتائج؟
توصي الدراسة بإجراء دورات تدريبية ومحاضرات تثقيفية للقابلات بشكل دوري ومستمر لتحديث معلوماتهن حول الاستراتيجيات المستخدمة في الوقاية وتدبير النزيف بعد الولادة.
References used
KHAN, S; WOJDYLA, D. WHO analysis of causes of maternal death: A systematic review. Lancet. 2006;367 (9516): 1066–74
CAMPBELL, O; GRAHAM, W. Strategies for reducing maternal mortality: 2006;368 (9543): 1284–99
World Health Organization. World Health Organization multicountry survey on maternal and newborn health. Geneva: WHO; 2012
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Considered inadequate maternity care during pregnancy and delivery largely responsible for the big annual losses for each of the parturient mothers and their newborns. So this study aimed to assess the midwives knowledge regarding the management of s
econd stage of labor, and to find out the association between their knowledge and personal data during second stage of labor. This descriptive study was conducted in three hospitals at lattakia city, on a sample of 160 midwife. Results of the study showed that the level of midwives information to the second stage of labor was average, and the study of the impact of personal data on the level of midwives information about the second stage of labor show a statistically significant relationship between age and the level of Midwives Information, and between educational level and the level of their knowledge. The study also showed that There were no statistically significant differences between the experience and the level of information midwives relationship. The study recommends that; installing in-service educational program for Midwives to upgrade the techniques necessary to assess, evaluate and improve the quality of care rendered to laboring women, and to put an emphasis on conducting training course for the Midwives in order to change their malpractices and updating their knowledge with regular supervision on their performance.
Chemotherapy drugs cannot tell the difference between of normal cells and cancer
cells. This means normal cells are damaged and this results in side effects, This damage
does not stop in the patient who receiving treatment but also extends to all e
mployees in
the health care sitting. Nurses are the main groups that are exposed to these drugs in
hospital setting Generally, the occupational activities that pose to greatest risk of exposure
are the preparation ,Transporting cytotoxic drugs, administration of antineoplastic agents,
cleaning of chemotherapy spills, and handling of waste. Nurses require specialized
knowledge and skills in order to ensure safety for both patients life and for their own safety
of the jobs. Because of available a lot of chemotherapy guidelines we Must assess
knowledge and skills nursing staff and assess the extent of their commitment to these
guidelines.
Objective: The objectives of this study were to assessment of knowledge and skill
of oncology nurses in chemotherapy administration.
Postpartum Hemorrhage (PPH) is the leading cause of maternal death worldwide. In the developing countries, it is responsible for the death of about 125 000 women each year. In most cases 67-80% are caused by uterine atony.
Uterine massage would re
present a simple intervention with the potential to have a major effect on PPH and maternal mortality in under resourced settings.
Aim: The aim of the present study is to study the effect of uterine massage on the immediate postpartum hemorrhage among primiparae.
Materials and Methods: The study was conducted of al-Assad Hospital and Children & Obstetrics Hospital (Lattakia), a convent sample of 40 primiparae women. Checklist application form was used to assess the postpartum hemorrhage by hemoglobin and hematocrit measurement before applying uterine massage and after the end of procedure.
Results: This study demonstrated that the rate of hemorrhage decreased in the experimental group, hemoglobin and hematocrit was higher (10.4 mg/dl, 32.3%) (P=0.029*) (P=0.015*) among primipara who received uterine massage.
Conclusions and Recommendations: Our present study results advice to apply uterine massage for all women after labor and delivery because its effective in reducing blood loss. It is also recommended to learn nurses how to apply uterine massage.
Nursing staff exposed to musculoskeletal problems associated with work while
providing nursing care because of the erroneous practice of mechanical body, This study
aimed to assess the level of nursing staff information about the use of mechanical
body and
the extent of their use of mechanical body within the nursing activities ,This study was
conducted on the author of a sample of 65 nurse in surgery and internal and intensive care
at University Hospital Assad where he was interviewed every nurse on the end were
evaluated their knowledge by assessing information form was then assess how their use of
body mechanics within specific activities in nursing care using the observational checklist ,
the study concluded that the level of information and practices of nursing staff about
mechanical body ranged between poor and average, the study recommended the need to
raise the level of information and practices of nursing staff about good mechanical body
through training and educational programs and lectures.
This search included 150 pregnant women who had gestational age of 36 weeks or more, and had been admitted to the Department of Obstetrics and Gynecology at Al – Assad University Hospital in Lattakia for the spontaneous vaginal delivery during the st
udy period
( 1\1\2012 to 1\7\ 2013). Exclusion criteria were patients undergoing cesarean section, patients with placenta previa, or abruptio placenta, patients with hemoglobin<9 gm%, pregnancy-induced hypertension or pre eclampsia–eclampsia, grand multiparty, coagulation abnormalities, positive history of PPH, expensive hemorrhage or other medical disorders.
Patients were randomly divided into three groups: ( 1: uterine massage group, 2: 10 units oxytocin in 500 cc glucose 5% intravenously with delivery of the anterior sholder\ control group, 3: three 200µg rectal misoprostol tablets\study group).
No significant differences were observed between the groups regarding baseline characteristics. There was blood loss of ≥500 ml occurred in 18% in the first group, 6% in the second group, 8% in the third group. Routine use of 600 µg of rectal misoprostol was effective in reducing blood loss after delivery ل gm%, pregnancyts with hemoglobin}ergoing cesarean section, patients with placenta pre and g (RR 0.44 ; CI 0.32 – 1.53), but not as effective as intravenous oxytocin (RR 1.33 ; CI 0.4 – 3.39).
Although these were differences, they were not significant (No significant differences were observed between the control and study groups for the length of the third stage of labor, the estimated blood loss, the changes in Hb and Hct concentrations, need for additional uterotonics, manual removal of placenta, blood transfusion…..).
This dose of misoprostol and route of administration were well tolerated, and usual side effects such as shivering and fever were transient, resolved on their own, and were not threatening. Because PPH is the most significant direct cause of maternal mortality and because most of these maternal mortality occurs in low resource countries, misoprostol offers several advantages over oxytocin in such settings. It is formulated as a tablet, widely available and affordable, and it does not need require special storage conditions (i.e. it is stable at ambient room temperature and does not require specific conditions for transfer and has a shelf-life of several years). It also does not require any special skills, equipment, or facilities for its use. So misoprostol can fill a service delivery gap in settings where women and providers are unable to access oxytocin.ل gm%, pregnancyts with hemoglobin}ergoing cesarean section, patients with placenta pre and g
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