AimsTo understand the perspectives and experiences of healthcare providers who have experience working with an enhanced recovery care after elective caesarean birth pathway with next‐day discharge and home midwifery.DesignThis study applies a qualitative study design with a pragmatic realist approach. The realist framework was used while also taking a post‐positivist philosophy.MethodsThe work was conducted in South Australia, Australia between May and October 2019. Twenty‐three semi‐structured interviews were completed with 5 doctors and 18 midwives who had occupational experience working with the pathway. Interviews were analysed using following the six‐phase qualitative thematic analysis process outlined by Braun and Clarke. COREQ guidelines were followed.ResultsFour main themes and 11 sub‐themes were identified. Main themes identified were as follows: The pathway is more than just early discharge; experiences with the process; staff engagement with the pathway; and the impact of the pathway within the health system.ConclusionHealthcare providers generally accepted the pathway and found enhanced recovery care to be a positive and beneficial model of care. Staff identified five main challenges with implementing the pathway: early discharge; eligible women's automatic inclusion on the pathway; engaging women; change for staff and organisational constraints and procedures. Elements that support integration include the following: education for women; reassurance and communication with women and families; prepared care and supports including home midwifery; staff education and communication of the evidence; clear guidelines and protocols; defined staff roles; enough clinical time and clinical flexibility.ImpactKnowledge from staff in this study would be useful for other health services to consider when looking to deliver similar models of care.Patient or Public ContributionThe health service and health providers were involved with the initiation and development of the research aims and design.

中文翻译：

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医疗保健提供者在择期剖宫产后第二天出院后提供加速恢复的经验和观点：定性分析


目的了解医疗保健提供者的观点和经验，这些提供者在选择性剖宫产后有次日出院和家庭助产后增强康复护理的经验。设计本研究采用实用现实主义方法的定性研究设计。在采用后实证主义哲学的同时，也使用了现实主义框架。方法该工作于 2019 年 5 月至 10 月在澳大利亚南澳大利亚进行。对 5 名医生和 18 名助产士完成了 23 次半结构化访谈，他们具有与该途径相关的职业经验。按照 Braun 和 Clarke 概述的六阶段定性主题分析过程对访谈进行分析。遵循 COREQ 指南。结果确定了 4 个主要主题和 11 个子主题。确定的主要主题如下： 途径不仅仅是早期出院;流程经验;员工参与 Pathway;以及该途径对卫生系统的影响。结论医疗保健提供者普遍接受该途径，并发现增强康复护理是一种积极且有益的护理模式。工作人员确定了实施该途径的五个主要挑战：早期出院;符合条件的女性自动纳入 PATHWAY;吸引女性参与;员工和组织限制和程序的变化。支持融合的要素包括：妇女教育;安抚妇女和家庭并与妇女和家庭沟通;准备好的护理和支持，包括家庭助产士;员工教育和证据交流;明确的指导方针和协议;确定员工角色;足够的临床时间和临床灵活性。ImpactKnowledge 来自本研究中工作人员的知识将有助于其他卫生服务机构在寻求提供类似护理模式时考虑。患者或公众贡献卫生服务和卫生提供者参与了研究目标和设计的启动和制定。