Study On The Current Status Of Clinical Implementation Of "Group Management Model Maternal Health Care Nursing Service Standards

Purpose:To investigate the status quo of clinical implementation of the "Group Management Mode Maternal Health Care Service Specification",and dig out the obstacles and promoting factors that affect its clinical implementation according to the results of the status quo,so as to provide evidence reference for promoting the clinical transformation of the "Group Management Mode Maternal Health Care Service Specification".Methods:This study is based on the consolidated framework for implementation research(CFIR)in implementation research(IR)(hereinafter referred to as CFIR framework).Self-made questionnaires were used to investigate the clinical implementation of"Group Management Mode Maternal Health Care Service Standard",and the stakeholders who implemented this standard were analyzed in the fields of intervention characteristics,external factors,internal factors,individual characteristics and implementation process.Through the investigation,it was found that individual characteristics had an impact on the clinical implementation of"Group Management Mode Maternal Health Care Service Standard",and further explored its obstacles and promotion factors in the field of individual characteristics.1.Self-made questionnaire according to CFIR framework,and the final draft of the questionnaire was determined by Delphi method.2.A self-made questionnaire was used to investigate the current situation of the clinical implementation of the "norms of maternal health care service in group management mode".With the method of convenient sampling,this paper conducted a questionnaire survey on the stakeholders who participated in the implementation of the "Group Management Mode Maternal Health Care Service Standard" in the third-class first-class hospitals in Liaoning Province,and analyzed their implementation status in the fields of intervention characteristics,external factors,internal factors,individual characteristics and implementation process.It was found that individual characteristics had an impact on the clinical implementation of the"Group Management Mode Maternal Health Care Service Standard".3.According to the survey results,the field of individual characteristics scored the lowest in all fields of CFIR framework,so the stakeholders who participated in the questionnaire survey were selected to conduct qualitative interviews on the elements in the field of individual characteristics.The content analysis method is used to analyze and sort out the data,and further explore the obstacles and promoting factors that affect the implementation of the "Group Management Mode Maternal Health Care Service Specification".Results:1.Delphi method results:The effective recovery rate of the two rounds of inquiry forms is 100%,and the participation rate of experts in the two rounds of inquiry is 40%and 20%respectively,so the participation and enthusiasm of experts are good.The authoritative coefficient(Cr)of the two rounds of experts is greater than 0.7,and the experts have good authority.The concordance coefficient of Kendall’s W was 0.215 and 0.232,respectively,and the significance test P values were both less than 0.01,which indicated that experts had a good degree of coordination.Finally,the final draft of the questionnaire on the implementation status of the maternal health care service standard in group management mode was formed,including 29 items in five dimensions,namely,the characteristics of the intervention program(5 items),the external characteristics field(4 items),the internal characteristics field(6 items),the individual characteristics field(9 items)and the implementation process field(5 items).2.Survey results:A total of 235 questionnaires were collected,and the scores of stakeholders in each field of CFIR framework from high to low are:the characteristic field of intervention plan(3.86±1.19),the implementation process field(3.86±1.16),the internal factor field(3.85±1.14)and the external factor field(3.82±1.15).Among them,the average value in the field of individual characteristics is much lower than that in other fields,which shows that stakeholders have an important influence on the implementation of the "Group Management Mode Maternal Health Care Service Specification" in the field of individual characteristics.3.Qualitative research results:According to the current survey results,15 stakeholders who participated in the questionnaire survey conducted semi-structured interviews on the elements in the field of individual characteristics,and summed up five obstacles(insufficient professional knowledge reserve,too clear work stage,too simple specification content,insufficient continuous use of specifications,lack of organizational support)and two promotion factors(high recognition of specifications and improved communication and empathy ability).Conclusion:1.Through the questionnaire survey,it is concluded that in the fields of intervention characteristics,external factors,internal factors,individual characteristics and implementation process under the CFIR framework,the score of individual characteristics is(3.62±0.96),and the education background,working years and professional titles of the stakeholders who implement the "Standard of Maternal Health Care Service in Group Management Mode" are the main factors affecting its clinical implementation.2.Obstacles in the field of individual characteristics in the clinical implementation of the "Group Management Mode Maternal Health Care Service Specification" are:insufficient professional knowledge reserve,too clear work stage,too simple specification content,insufficient continuous use of the specification,and lack of organizational support;The promoting factors are:high recognition of norms and improved communication and empathy ability.