陣痛室における夜勤帯の1対1看護の導入を試みて  [in Japanese] Innovation of one to one nursing system during nightshifts in the labor room  [in Japanese]

陣痛室での看護の良し悪しは,分娩の満足度を大きく左右するといわれている。しかし,夜勤帯で産婦の入院が重なると,スタッフがずっと付き添うことば困難となる。当院は以前から,夜間の緊急手術や分娩が重なったときなどの処置介助に備え,連日5〜6名の助産師と看護師を待機させてきたが,これまで実働する回数は非常に少ないものであった。そこで2003年8月からは,夜勤帯に産婦の入院が重なったときは,この待機スタッフを呼び出すことにして,陣痛室における夜勤帯の1対1看護を導入した。導入前の2002年8月〜2003年7月までの1年間では,27回,延べ67人の呼び出しがあったが,導入後の2003年8月〜2004年7月までの1年間では,78回,延べ141人に増加した。このうち,1対1看護のための呼び出しは,50回,延べ64人で,このために要した経費は,1年間で240,000円であった。退院時のアンケート調査を使って,分娩に対する産婦の満足度の推移を検討した結果,1対1看護の導入を契機に満足度は有意に増加し,不満な意見は減少傾向がみられた。しかし,有効陣痛開始前からの1対1看護を要望する産婦も多いことや,看護師よりも助産師を呼び出しがちになるため,次の勤務に支障が出ることなどが問題点であった。

It is recognized that the quality of nursing care in the labor room is very important for a parturient women's satisfaction. But, it is difficult to stay beside the parturient woman all the time especially atnight. We have a "call system" duirng the nightshift in cases of emergencies. However, this system wasn't used so often until August 2003, when we started to provide one to one nursing system in the labor room on nightshift. When parturient women came within a short time, we tried to use the nurse call system positively. Before the one to one nursing system, 27 calls and 67 staff members were called to report between August 2002 and July 2003, after the one to one nursing system was instituted, 78 calls and 141 staff members were called to report between August 2003 and July 2004. A total 50 time call and 64 staff members were called to report for the one to one nursing care, and \240,000 was the additional cost for this nursing system in a year. Satisfied voices have increased significantly, and unsatisfied voices have decreased considerably after innovation of the one to one nursing system during nightshift. However, there are several problems left, for example, many parturient women expect one to one nursing care before effective labor, and of course midwives are more likely to be called to report than nurses.