美国产科进展与服务模式课件.ppt

* LDR Room Features: Improved space for partner/visitors; fold-out sofa bed Increased space eliminates need for family to leave room to allow staff room to work * LDR Room Features: Bathroom facilities in all Labor Delivery rooms include tubs All Labor Delivery rooms can accommodate birthing tubs (except the 3 required ADA-compliant rooms) * Nursing “hubs” vs. stations Interdisciplinary conference rooms offer more privacy to discuss cases Multiple charting stations Call rooms with windows for OBs Designated sleep rooms for attendings Designated private rooms with locking doors for MDs * * * Improved floor plan provides more logical co-location of services, e.g.: NICU next to C-section, LDR NICU designed as private room, rather than “ward” setup Each patient room has observation windows so medical staff can monitor patients without having to physically walk into the room and interrupt/disturb patients * 护理产后病历 The Perinatal Education and Lactation Center 　　　　母乳喂养的禁忌症 HIV 活动期结核 病毒性人类T细胞白血病 母亲血铅水平大于 40 μg/dl 使用禁忌药物 (苯丙胺, 可卡因, 海洛因, 大麻) 接受放射性治疗 新生儿筛查 PKU （出生后12小时至6天内） 半乳糖血症 甲状腺功能减退 镰刀形红细胞病 其它血红蛋白疾病 出生新生儿 37 weeks: 新生儿 2500 grams: 新生儿 1500 grams: 足月新生儿5分钟 Apgars 7: 新生儿进入重症监护病房: 死胎数: 新生儿死亡数: 早产率: 低出生体重率: 极低出生体重率: 低 Apgar 评分率: 新生儿重症监护病房住院率: 死胎率: 新生儿死亡率： 568 465 90 34 368 25 16 10.1% 8.3% 21.6% 0.5% 6.5% 0.4% 0.2% CPMC 2010 产前住院时间： 15.5h 总住院时间: 3.1d 平均住院天数 　CPMC 2010 　　　　　 展　望 医疗服务普及化，真正做到人性化服务 剖宫产和自然分娩补助费用均等,避免道德危机 医务人员培训，德、术兼顾 产前检查全面化与规范化，灌输“新观念” 医疗规章修改与世界卫生组织接轨 对全社会宣教，促进“自然分娩”观念，增强孕产妇对妊娠、分娩、育儿的责任分担 注重医院内涵建设，改造医疗硬件，同时落实制度,简化病历及加强医疗品质管理与监控 　　　　　　目　标 孕产妇死亡率 围产儿及5岁以下儿童死亡率 剖宫产率 会阴侧切率 新生儿缺陷率 降低 California Pacific Medical Center San Francisco, California USA 感谢 北医三院 王妍医师 天津武警 于芳医师 唐山妇幼 季淑英医师 协助翻译 Asdf Currently, CPMC has three types of facilities and four campuses. First type is a community hospital at St. Luke’s Campus. Second is a specialty hospital at Davies. Third is tertiary facilities at the