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Oblikovanje nacionalnih protokolov za vodenje druge in tretje porodne dobe pri normalnem porodu : diplomsko delo
ID Virant, Kaja (Author), ID Mivšek, Ana Polona (Mentor) More about this mentor... This link opens in a new window, ID Drolc, Tatjana (Comentor), ID Petročnik, Petra (Reviewer)

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Abstract
Uvod: Za pripravo navodil za dobro prakso zdravstvene in babiške nege ter oskrbe je pristojen Upravni odbor Zbornice zdravstvene in babiške nege Slovenije – Zveze strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije, ki pripravlja nacionalne protokole. V slovenskem prostoru je oblikovanih malo smernic, ki bi babice vodile pri delu in s tem zagotovile enotno babiško obravnavo. Posledično prihaja tudi do razkoraka med poučevano teorijo in prakso, kar otežuje pripravo študentov na klinično usposabljanje. Namen: Namen diplomskega dela je ugotoviti, kakšno je optimalno vodenje 2. in 3. porodne dobe glede na dokaze najnovejših raziskav in na podlagi priporočil zdravstvenih organizacij napisati nacionalna protokola za vodenje 2. in 3. porodne dobe. S tem bomo zagotovili enotno in kakovostno babiško obravnavo, hkrati pa pridobili z dokazi podprto osnovo za pripravo izobraževalnega videoposnetka. Ta bo služil kot didaktični pripomoček pri pripravi bodočih babic in babičarjev na klinično prakso. Metode dela: Uporabljena je bila deskriptivna metoda dela s pregledom znanstvene in strokovne literature, podrobneje pa smo analizirali priporočila, objavljena na spletnih straneh organizacij: International Confederation of Midwives, National Institute for Health and Care Excellence, The American College of Obstetricians and Gynacologists, The International Federation of Gynecology and Obstetrics, The Royal College of Midwives in World Health Organization. Pri oblikovanju protokolov smo upoštevali Pravilnik o nacionalnih protokolih s področja zdravstvene in babiške nege ter oskrbe. V snemanje izobraževalnega videoposnetka smo vključili eno prostovoljko, ki je podpisala izjavo o zavestni in svobodni privolitvi k sodelovanju. Za snemanje smo pridobili soglasje Komisije za medicinsko etiko Republike Slovenije ter privolitev predstojnika ljubljanske porodnišnice. Glede varnosti in varovanja osebnih podatkov smo delovali v skladu z Zakonom o pacientovih pravicah, Zakonom o varstvu osebnih podatkov in Uredbo (EU) 2016/679 Evropskega parlamenta in sveta z dne 27. aprila 2016 o varstvu posameznikov pri obdelavi osebnih podatkov in o prostem pretoku takih podatkov ter o razveljavitvi Direktive 95/46/ES. S pametnim telefonom smo posneli 2. in 3. porodno dobo ter prvo oskrbo novorojenčka. Izobraževalni videoposnetek smo obdelali s pomočjo urejevalnika VSDC Free Video Editor družbe Multilab LLC. Slikovno gradivo je lastno delo avtorice diplomskega dela, glasbena podlaga pa je bila prenešena iz YouTubove zbirke brezplačnih glasbenih podlag brez avtorskih pravic Audio Library. Pisni komentarji v izobraževalnem videoposnetku se vsebinsko povezujejo z razvitima protokoloma, ki sta rezultat diplomskega dela. Rezultati: Nacionalni protokol za vodenje 2. porodne dobe opisuje naloge babice, kot so: spremljanje stanja porodnice in ploda, priprava porodnice na iztis, podpora porodnici, varovanje presredka in porajanje novorojenčka. Nacionalni protokol za aktivno vodenje 3. porodne dobe opisuje naloge babice, kot so: aplikacija uterotonika, ocena novorojenčka po Apgarjevi, spodbujanje kontakta kože na kožo, oznaka mame in novorojenčka z zapestnicama, pozno klemanje in prerez popkovine, porajanje posteljice, pregled mehke porodne poti, placente ter kontrola involucije maternice in krvavitve. Razprava in zaključek: Z izdelavo diplomskega dela smo pridobili optimalni nabor priporočil, na podlagi katerega smo oblikovali dva nacionalna protokola. S tem smo postavili pomembne temelje kakovostni, varni in enotni babiški obravnavi v času 2. in 3. porodne dobe ter pripravili izhodišče za nadaljnje pisanje protokolov babiške nege. Rezultati diplomskega dela so bili uporabljeni pri pripravi izobraževalnega videoposnetka, ki bo nedvomno pripomogel k zmanjšanju razkoraka med teorijo in prakso ter posledično izboljšal pripravljenost študentov babištva na klinično prakso.

Language:Slovenian
Keywords:diplomska dela, babištvo, nacionalni protokoli, smernice, varovanje presredka, klemanje popkovnice, porod placente
Work type:Bachelor thesis/paper
Typology:2.11 - Undergraduate Thesis
Organization:ZF - Faculty of Health Sciences
Place of publishing:Ljubljana
Publisher:[K. Virant]
Year:2021
Number of pages:68 str., [6] str. pril.
PID:20.500.12556/RUL-128402 This link opens in a new window
UDC:618.2/.7
COBISS.SI-ID:70175235 This link opens in a new window
Publication date in RUL:11.07.2021
Views:2416
Downloads:259
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Secondary language

Language:English
Title:Developing national protocols for the management of the second and third stage of normal labour : diploma work
Abstract:
Introduction: The Management Board of Nurses and Midwives Association of Slovenia is the institution responsible for writing national protocols for optimal nursing and midwifery practice. In Slovenia there is not enough guidelines that would lead midwives at their interventions and ensure equal midwifery care. Consequently, there is a great gap between theory taught at the faculty and clinical practice, which makes preparation of the students for their internship in a delivery ward much more difficult. Purpose: The main purpose of this thesis is to develop national protocols for management of the second and third stage of normal labour based on the recommendations of health organisations. This will help to ensure equal, quality, and safe midwifery care and help us to prepare an educational video, which will be used in midwifery education in the future. Methods: We used descriptive research methods and closely analysed recommendations of health organisations, such as: International Confederation of Midwives, National Institute for Health and Care Excellence, The American College of Obstetricians and Gynacologists, The International Federation of Gynecology and Obstetrics, The Royal College of Midwives and World Health Organization. The protocols were developed by filling out the forms posted on Nurses and Midwives Association of Slovenia’s website. The recommendations written in a document: »Pravilnik o nacionalnih protokolih s področja zdravstvene in babiške nege ter oskrbe« have been followed. In this thesis we included one volunteer who signed the statement of informed and voluntary consent. We recorded the second and third stage of labour and the baby care in a labour room with a smartphone. The educational video was edited with VSDC Free Video Editor developed by Multilab LLC. Pictures were created by the author of this thesis. The music used in the educational video is a free, no copyright music downloaded from a YouTube channel Audio Library. Comments written in the educational video are linked to the results of this thesis. Diploma thesis was approved by the National Medical Ethics Committee. Regarding safety and personal data processing Patients' Rights Act, Personal Data Protection Act and Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data and repealing Directive 95/46/EC« have been followed. Results: National protocol for the management of the second stage of labour describes monitoring mother’s and baby’s wellbeing, preparation of the woman and support during pushing, use of techniques for reducing perineal trauma and delivery of a newborn. National protocol for active management of the third stage of labour describes application of uterotonic, Apgar score assessment, encouraging skin-to-skin contact, mother and newborn labelling, cord clamping and cutting, delivery of the placenta, checking for the soft tissue injuries, placenta examination, controlling involution of the uterus and the amount of blood-loss. Discussion and conclusion: In this thesis we wrote the analysis of multiple recommendations for management of the second and third stage of labour. We developed two national protocols based on the findings of the analysis. Therefore, we set an important foundation for quality and safe midwifery care during the second and third stage of labour among all the midwives in the Republic of Slovenia. Furthermore, we created a good starting point for further research and national protocols' development. In addition, we used developed national protocols in the form of the educational video, which will help to close the gap between theory and practice and help to prepare students on their internship in maternity hospitals.

Keywords:diploma theses, midwifery, national protocols, recommendations, perineal protection, cord clamping, placenta delivery

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