| Project/Area Number |
18K17591
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| Research Category |
Grant-in-Aid for Early-Career Scientists
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| Allocation Type | Multi-year Fund |
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| Review Section |
Basic Section 58070:Lifelong developmental nursing-related
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| Research Institution | Nara Medical University |
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Principal Investigator |
Ueda Kayo 奈良県立医科大学, 医学部, 講師 (90637042)
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| Project Period (FY) |
2018-04-01 – 2024-03-31
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| Project Status |
Completed (Fiscal Year 2023)
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| Budget Amount *help |
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2021: ¥260,000 (Direct Cost: ¥200,000、Indirect Cost: ¥60,000)
Fiscal Year 2020: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2019: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2018: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
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| Keywords | Quality improvement / Quality of health care / Quality indicators / Obstetric delivery / Midwifery / Audit and Feedback / Childbirth / Clinical guideline / Quality Indicator / Feedback and Audit / Childbirth care / Low-risk / Prennancy / Health care / 妊娠や出産 / 低リスク出産 / 医療改善 / 医療の質指標 / 実装科学 / エビデンスに基づく介入 / ヘルスケア / 助産師 / low risk labor / quality indicator / quality improvement / Quality Improvement / 診療ガイドライン |
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| Outline of Final Research Achievements |
The care for low-risk childbirth, which accounts for the majority of births, is easily influenced by localities, delivery facilities, and medical personnel, and ensuring quality and safety is essential. We developed a quality indicator (QI) from several clinical practice guidelines and existing QIs using a modified Delphi method, and have been updating and verifying its applicability. The aim of this study is to develop and to assess a program to more effectively improve care for low-risk births using QI. From the review of the previous research, we developed the multifaceted intervention program including audit and feedback using indicators, and assessed the change to the performance by comparing before and after the intervention. The results showed that the intervention was effective in some indicators.
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| Academic Significance and Societal Importance of the Research Achievements |
低リスク出産のQIを用いた質改善の介入の実装とその効果の評価は、取り組むべき重要な課題である。質改善の介入は、ケアのプロセスと結果を改善するための戦略的なアプローチであり、監査とフィードバックが広く用いられているが、QIの測定結果の一方的報告だけでは効果は不十分とされている。また、質改善を実現するには組織的な取り組み等の多面的な実践が有効とされているが、低リスク出産の医療ケアでの取り組みは非常に限られている。そのため、本研究での取り組みや効果の検証の方法と結果は今後の医療の質改善に、産科医療だけでなく広い分野での応用に役立つであろう。
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