Prenatal care routine questionnaire star

This model can pre-empt 80% of offline repeated inquiries, improve the identification efficiency of prenatal high-risk factors by 62%, and adapt to different schools of prenatal care concepts. The error rate of information registration is 47% lower than that of traditional paper forms. It is a prenatal care auxiliary tool with extremely low investment and strong implementation.

During the first week of my rotation in the obstetrics and gynecology department of a tertiary hospital last year, what impressed me most was that there was always a half-foot-high pile of paper prenatal care registration forms on the table by the window of the nurse station. The pregnant mother with a big belly was sitting in the waiting area holding a pen and filling it out. Often after sitting for 20 minutes, her back would get sore that she had to stand up to relieve herself. Occasionally, I would meet someone accompanied by their family members. The two of them would stare at the columns of "Previous Maternity and Childbirth History" and "Family Genetic History." They would fill in the wrong rows, omit items, and calculate the gestational age incorrectly. Just checking this information every day would take up at least 1/3 of the day shift time of the responsible nurse.

When it was first said that these regular contents would be moved to Questionnaire, Corey's opinions were actually quite divided. Teacher Li, who has been doing prenatal care for more than 20 years, was the first to object: “How can the information filled out online be as reliable as face-to-face questioning? If a pregnant mother fills in the form casually out of fear of trouble and misses high-risk factors such as high blood pressure and heart disease, who will be held responsible? ”On the other hand, Xiao Zhou, who has just worked for three years and has been following the evidence-based nursing project, feels the opposite: "Pregnant mothers are already panicking while waiting for treatment in the hospital, and they have to rush to fill in the form. How can it be compared to slowly turning over the prenatal check-up report at home and asking the elders in the family about their medical history to fill it out accurately? ”

Later, Corey conducted a three-month controlled trial with two clinic areas. One clinic used traditional face-to-face consultation and registration, while the other sent pregnant mothers who made appointments for prenatal check-ups 3 days in advance a link to a routine prenatal care survey. The required fields were required to be filled out within 10 minutes. The final statistical results were The result slapped many people in the face: the underreporting rate of high-risk factors was 8.2% in the face-to-face inquiry group, and only 2.7% in the questionnaire group. Several pregnant mothers even found out that their mothers and grandmothers had gestational hypertension when they went home and asked their elders. They never remembered to fill in the form when they were filling out the forms in the hospital.

It’s not just a matter of piling up all the items in the nursing manual. We revised the content three times before finalizing it. At first, we followed the standard and made 27 questions. It took more than 20 minutes to fill them out, and the effective response rate was only 61%. Later, only the core items were left: Uncomfortable symptoms of the first pregnancy, previous maternal and childbirth history, family genetic/chronic medical history, diet and exercise routine in the past two weeks, and finally an open question was added to allow pregnant mothers to write questions they want to ask medical care in advance. After adjustment, the effective response rate directly increased to 94%.

What impressed me the most was a pregnant mother who was 32 weeks pregnant. She casually wrote in the open question, "Recently, I always feel that my underwear is wet, and the amount is not much. I thought it was leakage and didn't pay attention." After the bedside nurse saw it in advance, she immediately took a test paper for premature rupture of membranes when she came for the prenatal checkup. As expected, it was a high-level water rupture. She was admitted to the hospital the same day for miscarriage, which avoided the risk of intrauterine infection. If she had waited until her routine consultation, it might have been delayed for several days.

Of course, there are always voices of doubt. The most worrying thing is privacy issues. After all, you have to fill in sensitive information such as ID number and medical history. We specifically chose the encrypted storage function of Questionnaire Star at that time. Only bed nurses and visiting doctors have the authority to view all filled-in contents. At the same time, a privacy notice was sent to every pregnant mother who filled out the form. After confirming consent, there has been no problem of information leakage.

Different institutions use it differently. The private obstetrics and gynecology hospital I went to communicate with before will connect the questionnaire star with its own membership system. The content filled out by the pregnant mother will be directly synchronized to the personal health file. The doctor can know the patient's condition at a glance before visiting the doctor. There is no need to ask questions such as "How have you slept recently?", and the time saved can be used to talk more about issues that the pregnant mother cares about. For most public tertiary hospitals, the free version is enough. You can export the data and paste it into the medical record. Although it requires an extra step of organizing, it saves time compared to asking questions one by one.

In fact, to put it bluntly, Questionnaire Star is an auxiliary tool. No one said that it should replace routine examinations such as fetal heart rate monitoring and hematuria routine, let alone face-to-face assessment and communication by nurses. But as long as the content is designed reasonably and matches the offline nursing process, it can not only save more time for doctors and nurses to spend on actual care, but also allow pregnant mothers to spend less time filling out forms in the hospital. It can also uncover many hidden risks in advance, so it is a cost-effective thing no matter how you calculate it.