Effect of clinical care pathway in the prevention of postpartum syncope

Abstract

Objective To use clinical pathway project and method to prevent and reduce postpartum syncope,in order to provide clinical care path for reference for hospitals to prevent accidents in the implementation of total quality management.Methods According to high-risk score chart NESBITT,180 expectant mothers from September 2009 to July 2010,those who had complications and elder primipara eliminated,were evaluated.They were divided into two groups,each of which had 90 cases.The differences of age,week of pregnancy,times of births,position of fetus and standard of culture of two groups were not statistically significant ( P ＞ 0.05 ).Both groups received breast feeding promotion,nursing safety notice before entering the delivery room,and conventional care,while the observation group also received full-time care by nurses according to the clinical pathway of natural childbirth.Nursing procedures were divided into admission,before,during and 4 hours after delivery according to the pathway.Maternity patients' time of labor stage,blood pressure,postpartum bleeding,psychological status and postpartum syncope were compared between two groups.Results The time of labor stage of the observation group was(638 ± 163.2)min and that of the control group was (714 ± 204.6)min,postpartum systolic pressure before leaving the bed of the observation group was ( 120.57 ± 5.46) mm Hg and that of the control group was ( 106.62 ± 7.72 )mm Hg,analgesic effect of the observation group was 94％ and that of the control group was 44％,and the rate of postpartum syncope of the observation group was 1.1％ and that of the control group was 11.1％.All differences were statistically significant (t =2.683,4.73;x2 =53.02,7.84,respectively;P ＜0.05).Conclusions Clinical care pathway can effectively prevent postpartum syncope and reduce accidents in wards. Key words: Postpartum syncope; Clinical care pathway; Accidents