Developing a clinical care pathway for obese pregnant women: A quality improvement project

ProblemObesity in pregnancy is associated with an increased incidence of maternal and foetal morbidity and mortality, from conditions like preeclampsia, gestational diabetes, preterm birth and stillbirth. Between 20% and 25% of pregnant women in Australia are presenting to their first antenatal appointment with a body mass index (BMI) ≥30 kg/m², defined as obesity in pregnancy. These figures are concerning for midwifery and obstetric staff directly involved in the clinical care of these women and their families. In the absence of national or state clinical practice guidelines for managing the risks for obese pregnant women, a local quality improvement project was conducted.AimTo plan, implement, and evaluate the impact of an alternative clinical care pathway for pregnant women with a BMI ≥ 35 kg/m² at their first antenatal visit.Project settingThe project was undertaken in the antenatal clinic of a rural referral hospital in NSW, Australia.SubjectsEighty-two women with a BMI ≥ 35 kg/m² were eligible for the alternative care pathway, offered between January and December 2010.InterventionThe alternative care pathway included the following options, in addition to usual care: written information on obesity in pregnancy, referral to a dietitian, early plus repeat screening for gestational diabetes, liver and renal function pathology tests, serial self-weighing, serial foetal growth ultrasounds, and a pre-labour anaesthetic consultation.FindingsDespite being educated on the risk associated with obesity in pregnancy, women did not take up the offers of dietetic support or self-weighing at each antenatal visit. Ultrasounds were well received and most women underwent gestational diabetes screening.     

我国高科技企业战略人力资源管理现状及策略

分析当前我国经济转型期高科技企业战略人力资源特点和人力资源管理的现状,提出了提升人力资源管理战略定位,建立公平、高效绩效管理体系,建立以能力为基础、以绩效为导向的薪酬模式,加强培训和职业规划等软激励建设,构建以人为本,内涵深厚、充满活力的企业文化。     

大连经济技术开发区人口流迁特点及对策

开发区是我国经济发展的先导区。自大连经济技术开发区组建至今,人口流迁在其人口和经济、社会发展中的作用已变得越来越明显。本文结合“五普”资料,对大连经济技术开发区人口流迁的特点进行了分析,探讨了其中所存在的问题并结合这些特点和问题提出了有关的政策性建议。     

What attributes do Australian midwifery leaders identify as essential to effectively manage a Midwifery Group Practice?

Background

Despite well-known benefits of continuity of midwifery care, less than 10% of women have access to this model of care in Australia. Staff retention and satisfaction are strongly related to the quality of management; however, little is known about the attributes required to effectively manage a midwifery group practice.

入世后我国人口管理政策法规调适研究

入世后人口管理领域政策法规的调适是毋庸置疑的。当然 ,调适不是全盘西化 ,人口管理领域的政策法规调适首先应解决好指导思想问题 ,即“调适”应立足中国国情 ,在顺应国际规则的前提下 ,利用国际发展平台 ,进一步推动人口领域市场化改革。应把握的几个具体原则是 :法律本土化原则 ,与改革大局同步原则 ,顺应规则与利用规则相结合原则 ,循序渐进原则等     

中国市场化进程中人口管理模式的转变

市场化是当代中国最深刻的社会变革,而人口变动也是近几十年以来最显著的现象之一。一方面,人口变动推动了中国的市场化进程;另一方面,市场化变革要求中国的人口管理模式从计划经济下的他律型人口管理模式向市场经济下的自律型人口管理模式转变。     

构建社区管理主体和谐关系

社区管理主体组织存在着许多问题。以社区为中心规定居民委员会、业主委员会和物业管理公司之间的关系,加强各组织建设是构建社区管理主体和谐关系的途径。     

云南省民办高等教育管理体制改革探析

云南省的民办高等教育近年来获得了较大的发展,但也面临着许多困难和问题。本文是在对云 南民办高等教育的充分调研的基础上,分析了云南民办高等教育管理体制的现状和存在的主要问题, 探讨其在今后的改革对策和发展思路。     

档案管理浅见

档案工作是学校工作的重要组成部分 ,做好档案工作应从管理体制、管理制度、业务建设、开发利用四个方面进行。     

环境审计的比较研究

本文在对环境审计(EA)进行解释和分类的基础上,对三大环境审计即房地产交易审计(PTA)、清洁生产审计(CPA)和环境管理体系审计(EMSA)进行了比较研究,最后提出了环境审计的核心问题和实施环境审计所需搭建的平台.