Nurses' Knowledge of and Confidence in Perioperative Skills for Emergency Cesarean Birth.

OBJECTIVE: To assess if nurses' perioperative knowledge of and confidence in perioperative skills for emergency cesarean birth improved after didactic learning and high-fidelity simulation. DESIGN: Descriptive, one-group pretest and posttest design. SETTING/LOCAL PROBLEM: Level 3 labor and birth unit that averages 3,000 births per year. At the site, there were no current evidence-based programs specifically focused on perioperative skills sustainment of the maternity nursing professional. PARTICIPANTS: Registered nurses on a labor and birth unit with at least 1 year of experience completed an online educational course and simulation activity. INTERVENTIONS/MEASUREMENTS: Participants were given pretests and posttests to assess knowledge and confidence in emergency cesarean birth perioperative skills. Observations of nurses' pretest and posttest interventions in cesarean births were made to assess changes in competency. Chart reviews were completed to assess changes in decision-to-incision time before and after the intervention. RESULTS: Nurses reported greater confidence and knowledge during emergency cesarean birth after participating in the interventions. Other results included decreased decision-to-incision times. None of these results held statistical significance. CONCLUSION: This project highlights the need for evidence-based, standardized perioperative maternity education across labor and birth nursing practice.

Caracterização ao nascimento e nutricional dos prematuros em unidade intensiva de um hospital público / Characterization at birth and nutritional of premature newborns in the intensive unit of a public hospital

A prematuridade está associada à mortalidade infantil, um problema de saúde pública global. O objetivo deste estudo foi caracterizar o perfil ao nascimento e nutricional de prematuros em unidade intensiva, de hospital público, Paraná. Estudo prospectivo, quantitativo, realizado de janeiro a abril de 2020. Total de 16 internações, prevalência do sexo masculino (56,3%) e, nascimentos cirúrgicos (62,5%). Metade dos recém-nascidos eram prematuros extremos, muito prematuros e, extremo baixo peso; todos, com diagnóstico CID-10 de desconforto respiratório do recém-nascido; Apgar ≥7 no 5º minuto (75,0%); ocorreu um óbito. Nutrição parenteral e/ou enteral até 72 horas de vida ocorrida para 13 recém-nascidos prematuros (81,3%); 14 prematuros extremos com nutrição parenteral até o terceiro dia (87,5%); e, todos os muito prematuros (n=8) com nutrição enteral. O (re)conhecimento do cenário propicia a qualificação da atenção às gestantes e aos recém-nascidos, quanto ao planejamento do cuidado seguro e, ao estado nutricional, repercutindo na sobrevida. (AU)

Prematurity is associated to child mortality, a public health problem. The aim of this study was to characterize the birth and nutritional profile of preterm infants in an intensive care unit at a public hospital. Prospective, quantitative study, carried out from January to April 2020. Total of 16 hospitalizations with male prevalence (56.3%) and surgical births (62.5%). Half of the newborns were extremely premature, very premature, and extremely low birth weight. All of newborns with a diagnosis of respiratory distress of the newborn and Apgar score ≥7 in the 5th minute (75.0%). During the data collection, there was a death. Parenteral and/or enteral nutrition up to 72 hours of life occurred for 13 premature newborns (81.3%) 14 extremely preterm infants with parenteral nutrition until the third day of life (87.5%) and all very premature (n = 8) with enteral nutrition. The recognition of the scenario provides the qualification of care to pregnant women and newborns, regarding the planning of safe care and nutritional status affecting survival. (AU)

Connecting With Adolescent Mothers: Perspectives of Hospital-Based Perinatal Nurses.

Adolescent mothers are more likely to be dissatisfied with their perinatal nursing care than adult mothers. The purpose of this interpretive descriptive study was to explore adolescent-friendly care from the perspective of hospital-based perinatal nurses. Twenty-seven interviews were conducted with nurses with expertise caring for adolescent mothers. Open-ended questions were used to determine how they adapted their nursing practice when caring for adolescents, how they learned to provide adolescent-friendly care, and the facilitators and barriers to providing adolescent-friendly care. Nurses described two main goals: (a) delivering a positive experience and (b) ensuring mother and infant safety. They accomplished these goals by being nonjudgmental, forming a connection, and individualizing nursing care. The nurses described being mother-friendly, regardless of maternal age, and employing strategies to develop a nurse-adolescent mother therapeutic relationship. This research contributes to our understanding of how hospital-based perinatal nurses engage and support adolescent mothers.

Morbidade e mortalidade infantil com foco nas causas perinatais no nordeste brasileiro / Analysis of morbidity and mortality indicators of perinatal causes in children under one year in northeastern Brazilian / Analisis de los indicadores de morbilidad y mortalidad de causas perinatales en hijos bajo un año en el norte brasileño

Introdução:Uma das fases da vida na qual o ser humano está mais sujeito a sofrer com o processo demorbimortalidade é a infância.Isso é ocasionada por diversos fatores, que tornam esse ciclo de vida ofoco,quando se trata do estudo de mortalidade e morbidade infantil. Objetivo:analisar a morbidade hospitalar e mortalidade infantil por causas perinatais em menores de um ano no nordeste brasileiro no período de 2013 a 2017.Metodologia:Caracteriza-se como estudo do tipo ecológico, realizado a partir de dados secundários extraídos do Departamento de Informática do Sistema Único de Saúde oriundos do Sistema de Informação de Mortalidade e o Sistema de Informação Hospitalar do Sistema Único de Saúde, no período de 2013 a 2017.Resultados: Revelaramque as causas perinatais são grandes contribuintes para a mortalidade. Dos fatores que mais matam estão à septicemia bacteriana (30,7%) e afecções maternas (42,3%). O ano de 2013 e o estado da Bahia revelaram um maior número de óbitos. Quanto à morbidade pode-se observar os agravos afecções do período perinatal (33,8%) e transtornos respiratórios do período perinatal (49,7%) sendo aqueles com maior número de casos, além do ano de 2017 e o estado da Bahia como sendo os que apresentaram maior número de internações. Conclusões:As causas perinatais são um dos principais fatores responsáveis por gerar vítimas, tornando-se necessária a tomada de medidas. Deve-se melhorar a transmissão de conhecimentos a fim de prevenir as doenças e fortalecer a promoção à saúde e reduzir as taxas de morbimortalidade (AU).

Introduction:One of the stages of life in which the human being is most likely to suffer from the process of morbidity and mortality is childhood. This is caused by several factors, which make this life cycle the focus, when it comes to the study of infant mortality and morbidity.Objective:analyze hospital morbidity and infant mortality from perinatal causes in children under one year in northeastern Brazil from 2013 to 2017. Methodology:It is characterized as an ecological study, carried out from secondary data extracted from the Informatics Department of the Unified Health System from the Mortality Information System and the Hospital Information System of the Unified Health System, from 2013 to 2017.Results:They revealed that perinatal causes are major contributors to mortality. Of the factors that kill the most are bacterial septicemia (30.7%) and maternal disorders (42.3%). 2013 and the state of Bahia revealed a greater number of deaths. Morbidity can be observed the diseases affecting the perinatal period (33.8%) and perinatal respiratory disorders (49.7%) being those with the highest number of cases, in addition to 2017 and the state of Bahia as the ones with the highest number of hospitalizations.Conclusions:Perinatal causes are one of the main factors responsible for generating victims, making it necessary to take action. Knowledge transmission should be improved in order to prevent diseases and strengthen health promotion and reduce morbidity and mortality rates (AU).

Introducción: Una de las etapas de la vida en la que el ser humano tiene más probabilidades de sufrir el proceso de morbilidad y mortalidad es la infancia. Esto es causado por varios factores, que hacen que este ciclo de vida sea el foco, cuando se trata del estudio de la mortalidad y la morbilidad infantil.Objetivo: analizar la morbilidad hospitalaria y la mortalidad infantilpor causas perinatales en niños menores de un año en el noreste de Brasil de 2013 a 2017.Metodología: Se caracteriza por ser un estudio ecológico, realizado a partir de datos secundarios extraídos del Departamento de Informática del Sistema Unificado de Salud del Sistema de Información de Mortalidad y del Sistema de Información Hospitalaria del Sistema Unificado de Salud, de 2013 a 2017.Resultados: Revelaron que las causas perinatales son los principales contribuyentes a la mortalidad. De los factores que más matan son la septicemia bacteriana (30,7%) y los trastornos maternos (42,3%). 2013 y el estado de Bahía revelaron un mayor número de muertes. Se pueden observar la morbilidad de las enfermedades que afectan al período perinatal (33,8%) y trastornos respiratorios perinatales (49,7%) siendo aquellos con mayor número de casos, además de 2017 y el estado de Bahía como los que tienen el mayor número de hospitalizaciones.Conclusiones: Las causas perinatales son uno de los principales factores responsables de generar víctimas, por lo que es necesario tomar medidas. Debe mejorarse la transmisión de los conocimientos a fin de prevenir enfermedades y fortalecer la promoción de la salud y reducir las tasas de morbilidad y mortalidad (AU).

Desfechos perinatais de gestantes com pré-eclampsia grave: estudo transversal / Resultados perinatales de mujeres embarazadas con preeclampsia severa: estudio transversal / Perinatal outcomes of pregnant women with severe pre-eclampsia: cross-sectional study

OBJETIVOS: Investigar os desfechos perinatais de gestantes com diagnóstico de pré-eclâmpsia grave. MÉTODOS: Estudo transversal desenvolvido em uma maternidade-escola, com amostra de 157 fetos/neonatos de gestantes com diagnóstico de pré-eclâmpsia grave. Para análise dos dados foram calculados os valores de estatísticas descritiva com uso do SPSS 21.0. RESULTADOS: Em 22,3% dos casos a gestação evoluiu com diagnóstico de restrição de crescimento intra-uterino. O óbito fetal teve incidência de 7,6%. Dos neonatos, 48% nasceram com idade inferior a 37 semanas e mais da metade (56,7%) foram classificados como de baixo peso. O índice de APGAR no primeiro e quinto minutos foram compatíveis com anóxia moderada. 20,4% dos recém-nascidos necessitaram de reanimação e 18,5% foram admitidos na unidade de terapia intensiva neonatal. CONCLUSÕES: A pré-eclâmpsia repercutiu com a presença da restrição de crescimento intrauterino, óbito fetal, prematuridade, baixo peso, necessidade de reanimação neonatal e admissão na unidade de cuidados intensivos.

OBJETIVOS: Investigar los resultados perinatales de mujeres embarazadas diagnosticadas con preeclampsia severa. MÉTODOS: estudio transversal realizado en un hospital de maternidad escolar, con una muestra de 157 fetos/neonatos de mujeres embarazadas diagnosticadas con preeclampsia severa. Para el análisis de datos, los valores estadísticos descriptivos se calcularon utilizando SPSS 21.0. RESULTADOS: en el 22,3% de los casos, el embarazo evolucionó con un diagnóstico de restricción del crecimiento intrauterino. La muerte fetal tuvo una incidencia del 7,6%. De los recién nacidos, el 48% nacieron menores de 37 semanas y más de la mitad (56,7%) se clasificaron como de bajo peso. El índice APGAR en el primer y quinto minutos fueron compatibles con anoxia moderada. El 20,4% de los recién nacidos requirió reanimación y el 18,5% ingresó en la unidad de cuidados intensivos neonatales. CONCLUSIONES: la preeclampsia tuvo repercusiones con la presencia de restricción del crecimiento intrauterino, muerte fetal, prematuridad, bajo peso, necesidad de reanimación neonatal y admisión a la unidad de cuidados intensivos.

OBJECTIVES: To investigate the perinatal outcomes of pregnant women diagnosed with severe pre-eclampsia. METHODS: Cross-sectional study carried out in a maternity school, with a sample of 157 fetuses/neonates of pregnant women diagnosed with severe pre-eclampsia. For data analysis, the values of descriptive statistics were calculated using SPSS 21.0. RESULTS: In 22.3% of cases, pregnancy evolved with a diagnosis of intrauterine growth restriction. There was an 7.6% incidence of fetal death. Among the neonates, 48% were born younger than 37 weeks and more than half (56.7%) were classified as underweight. The APGAR index in the first and fifth minutes were compatible with moderate anoxia. 20.4% of newborns required resuscitation and 18.5% were admitted to the neonatal intensive care unit. CONCLUSIONS: Pre-eclampsia had repercussions with the presence of intrauterine growth restriction, fetal death, prematurity, low weight, need for neonatal resuscitation and admission to the intensive care unit.

Autonomía profesional de la enfermería perinatal: percepción social de competencias conquistadas / Autonomia profissional na enfermagem perinatal: percepção social de competências conquistadas / Professional autonomy for perinatal nurses: social perception of competences gained

Objetivo: determinar el tipo de autonomía que ejerce la enfermera perinatal en una maternidad con intervención exclusiva por enfermeras según la percepción de las usuarias. Metodología: investigación con enfoque cualitativo, descriptivo, orientado por la teoría de representaciones de Moscovici, se desarrolló de junio a agosto de 2016, siendo el escenario de una maternidad. Como actores sociales tuvimos treinta y cuatro pacientes que recibieron atención en la fase perinatal. A partir de la información obtenida de las entrevistas se codificaron los datos extrayendo las categorías que fueron discutidas. Resultados: emergieron educación, cultura, humanismo, género y administración. Conclusión las usuarias percibieron un modelo de atención del parto natural de acuerdo a cuidados basado en la educación intercultural, que posibilitan un cuidado humanizado personalizado de las enfermeras para madre, padre e hijo.

Objetivo: Determinar o tipo de autonomia que exerce a enfermeira perinatal em uma maternidade com atendimento exclusivamente, realizada por enfermeiras, segundo a percepção das clientes. Metodologia: pesquisa realizada de junho a agosto de 2016, sendo o cenário em uma Maternidade, com enfoque qualitativo, descritivo, orientada pela teoria das representações sociais de Moscovici. As participantes foram 34 clientes que receberam o atendimento durante a fase perinatal. A partir das informações obtidas, por meio das entrevistas, codificaram-se os dados e emergiram-se as categorias. Resultados: apontou como categorias a educação, a cultura, o humanismo, o género e administração. Conclusão: As clientes percebem um modelo de atendimento do parto natural assente em cuidados baseados na educação intercultural, que possibilita um cuidado humanizado pessoalizado pelas enfermeiras para mãe, pai e filho.

Objective: to determine, according to user perceptions, the type of autonomy exercised by perinatal nurses at a maternity facility with care provided exclusively by nurses. Methodology: this qualitative, descriptive study, conducted at a maternity facility from June to August 2016, was guided by Moscovici's theory of social representations. The participants were 34 patients who received care during the perinatal phase. Data were codified from information obtained in interviews. Results: from the study, the following categories emerged; education, culture, humanism, gender and administration. Conclusion: users perceived a natural birth care model resting on care based on intercultural education, which made for humanized nursing care for mother, father and child.

Percepción social de usuarias atendidas exclusivamente por enfermeras en la etapa perinatal / Social perception of users served exclusively by nurses at the perinatal stage / Percepção social de usuários atendidos exclusivamente por enfermeiros no estágio perinatal

Resumen 19. El artículo muestra la atención exclusiva de enfermeras en una maternidad, cuyo objetivo fue analizar las representaciones sociales de las usuarias acerca de la atención brindada por las enfermeras obstetras en la institución. Es una investigación con enfoque cualitativo, descriptivo; direccionado por la teoría de las representaciones sociales de Moscovici. Se entrevistó a 34 mujeres atendidas en la maternidad. El análisis de datos se efectuó mediante marco interpretativo, seleccionando las ideas destacadas por medio de técnica cromática; en seguida, se discute los datos empíricos confrontados con la teoría. Las usuarias señalan que la atención recibida se inscribió en un marco de humanización, responsabilidad y confianza, lo cual posibilita la atención de un parto de acuerdo con sus costumbres que, con base en la teoría, refleja autonomía profesional. Se concluye que el modelo de atención muestra que el cuidado de enfermería se basa en conocimientos, experiencia y valores que potencializan la práctica, desde la que se aprecia el cuidado humano, cálido y personalizado.

Abstract 23. The article shows the exclusive attention of nurses in a maternity, whose objective was to analyze the social representations of the users about the attention given by the obstetric nurses in the institution. It is a research with a qualitative, descriptive approach; Directed by the theory of social representations of Moscovici. 34 women attended in the maternity were interviewed. The data analysis was carried out through an interpretative framework, selecting the ideas highlighted by means of chromatic technique; next, the empirical data confronted with the theory is discussed. The users point out that the care received was part of a framework of humanization, responsibility, and trust, which makes it possible to attend a delivery according to their customs, which, based on theory, reflects professional autonomy. It is concluded that the care model shows that nursing care is based on knowledge, experience, and values ​​that potentiate the practice, from which human care is appreciated, warm and personalized.

Resumo 27. O artigo mostra a atenção exclusiva dos enfermeiros em uma maternidade, cujo objetivo foi analisar as representações sociais dos usuários sobre os cuidados prestados pelas enfermeiras obstétricas na instituição. Trata-se de uma pesquisa com abordagem qualitativa, descritiva; dirigido pela teoria das representações sociais de Moscovici. Participaram 34 mulheres atendidas na maternidade. A análise dos dados é realizada através de um quadro interpretativo, selecionando as ideias destacadas por meio da técnica cromática; em seguida, os dados empíricos confrontados com a teoria são discutidos. Os usuários indicaram que o atendimento recebido fazia parte de um quadro de humanização, responsabilidade e confiança, que possibilita atender a um parto de acordo com seus costumes, o que, baseado na teoria, reflete a autonomia profissional. Conclui-se que o modelo assistencial mostra que o cuidado de enfermagem é baseado no conhecimento, experiência.

Transmissão vertical da sífilis: vivência materna durante a hospitalização para diagnóstico e tratamento de seu filho recém-nascido / Congenital syphilis: maternal experience during the hospitalization for diagnosis and treatment of her infant newborn / Transmisión vertical de sífilis: vivencia materna durante la hospitalización para el diagnóstico y tratamiento de su hijo recién nacido

Introdução: O diagnóstico e tratamento da sífilis congênita requer internação mais prolongada do\r\nrecém-nascido na maternidade, trazendo preocupação e ansiedade materna. Objetivo: Compreender\r\na experiência materna de ter seu fi lho internado para tratamento da sífilis congênita. Método: Estudo\r\ncom desenho qualitativo que adotou a Teoria Fundamentada nos Dados como referencial metodológico.\r\nParticiparam do estudo 11 puérperas cujos fi lhos estavam internados na unidade neonatal de um hospital\r\nescola de São Paulo para tratamento de sífilis congênita. Os dados foram obtidos por meio de entrevista.\r\nResultados: Dois fenômenos emergiram dos dados analisados: "Vivenciando o impacto do diagnóstico\r\nda sífilis" e "Vivenciando a internação do fi lho". Priorizando o tratamento do fi lho acima da minha saúde\r\ne bem-estar é o lema que representa a categoria central da vivência materna. Conclusão: A experiência\r\nmaterna é melhor enfrentada quando a mãe recebe apoio familiar e a abordagem assistencial dos profissionais é isenta de preconceitos e julgamentos.

Introduction: The diagnosis and treatment of congenital syphilis requires more prolonged hospitalization\r\nof the newborn in the maternity ward, causing maternal concern and anxiety. Objective: To understand\r\nthe maternal experience of having her child hospitalized for the treatment of congenital syphilis. Method:\r\nQualitative research by Grounded Theory approach. The study included 11 postpartum women whose\r\nchildren were hospitalized to congenital syphilis treatment at a university hospital neonatal unit, in the\r\ncity of São Paulo, Brazil. Data were collected by interview. Results: Two phenomena emerged from analyzed data: "Living the impact of syphilis diagnosis" and "Experiencing the hospitalization of the child".\r\nPrioritizing the treatment of the child above my health and well-being is the motto that represents the central category of maternal experience. Conclusion: Maternal experience is best faced when the mother\r\nreceives family support and the professional approach is free of prejudices and judgments.

Introducción: El diagnóstico y tratamiento de la sífilis congénita requiere una internación más prolongada\r\ndel recién nacido en la maternidad, trayendo preocupación y ansiedad materna. Objetivo: Comprender\r\nla experiencia materna de tener su hijo internado para el tratamiento de la sífilis congénita. Método: El\r\nestudio adoptó la Teoría Fundamentada en los Datos como referencial metodológico. Participaron del\r\nestudio 11 puérperas cuyos hijos estaban internados en la unidad neonatal de un hospital escuela de\r\nSão Paulo para tratamiento de sífilis congénita. Los datos fueron obtenidos por medio de entrevistas.\r\nResultados: Dos fenómenos emergieron de los datos: "Vivenciando el impacto del diagnóstico de la\r\nsífilis" y "Vivenciando la hospitalización del hijo". Priorizando el tratamiento del hijo por encima de mi\r\nsalud y bienestar es el lema que representa la categoría central de la experiencia materna. La experiencia materna es mejor enfrentada cuando la madre recibe apoyo familiar y el abordaje asistencial de los\r\nprofesionales está exenta de prejuicios y juicios.

An Early History of Anesthesia in Labor.

Fear of pain often overshadows childbirth, and each woman must decide whether to receive anesthesia to combat labor pain. Historically, this choice resulted in unintended consequences and marked the beginnings of medical interventions in labor and birth. The purpose of this article is to trace the use of anesthesia in childbirth from the mid-19th to the mid-20th centuries and to explore its influence on childbearing women and nurses.

Accessing new understandings of trauma-informed care with queer birthing women in a rural context.

AIMS AND OBJECTIVES: Participant narratives from a feminist and queer phenomenological study aim to broaden current understandings of trauma. Examining structural marginalisation within perinatal care relationships provides insights into the impact of dominant models of care on queer birthing women. More specifically, validation of queer experience as a key finding from the study offers trauma-informed strategies that reconstruct formerly disempowering perinatal relationships. BACKGROUND: Heteronormativity governs birthing spaces and presents considerable challenges for queer birthing women who may also have an increased risk of trauma due to structurally marginalising processes that create and maintain socially constructed differences. DESIGN: Analysis of the qualitative data was guided by feminist and queer phenomenology. This was well suited to understanding queer women's storied narratives of trauma, including disempowering processes of structural marginalisation. METHODS: Semistructured and conversational interviews were conducted with a purposeful sample of thirteen queer-identified women who had experiences of birthing in rural Nova Scotia, Canada. RESULTS: Validation was identified as meaningful for queer women in the context of perinatal care in rural Nova Scotia. Offering new perspectives on traditional models of assessment provide strategies to create a context of care that reconstructs the birthing space insofar as women at risk do not have to come out as queer in opposition to the expectation of heterosexuality. CONCLUSIONS: Normative practices were found to further the effects of structural marginalisation suggesting that perinatal care providers, including nurses, can challenge dominant models of care and reconstruct the relationality between queer women and formerly disempowering expectations of heteronormativity that govern birthing spaces. RELEVANCE TO CLINICAL PRACTICE: New trauma-informed assessment strategies reconstruct the relationality within historically disempowering perinatal relationships through potentiating difference which avoids retraumatising women with re-experiencing the process of coming out as queer in opposition to the expectation of heterosexuality.

Research About Nurse Staffing During Labor and Birth is Greatly Needed and Long Overdue.

Research about the effects of nurse staffing in the perinatal setting has been limited. To guide practice and ensure optimal outcomes, data are greatly needed on the type and amount of nursing care needed by women and their fetuses during labor. The Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) is sponsoring a study about nursing care during labor and birth with a focus on potential relationships between missed care (delayed, unfinished, or completely missed nursing care that was expected as part of routine care for childbearing women and their fetuses/newborns during the labor and birth process and the 2-hour postpartum recovery period) and nurse staffing and selected patient outcomes. Findings may support practice recommendations and suggest directions for future research.

Patient Safety Implications of Electronic Alerts and Alarms of Maternal - Fetal Status During Labor.

When nurses care for women during labor, they encounter numerous alerts and alarms from electronic fetal monitors and their surveillance systems. Notifications of values of physiologic parameters for a woman and fetus that may be outside preset limits are generated via visual and audible cues. There is no standardization of these alert and alarm parameters among electronic fetal monitoring vendors in the United States, and there are no data supporting their sensitivity and specificity. Agreement among professional organizations about physiologic parameters for alerts and alarms commonly used during labor is lacking. It is unknown if labor nurses view the alerts and alarms as helpful or a nuisance. There is no evidence that they promote or hinder patient safety. This clinical issue warrants our attention as labor nurses.

Consequences of Inadequate Staffing Include Missed Care, Potential Failure to Rescue, and Job Stress and Dissatisfaction.

OBJECTIVE: To evaluate responses of registered nurse members of the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) to a survey that sought their recommendations for staffing guidelines and their perceptions of the consequences of inadequate nurse staffing. The goal was to use these member data to inform the work of the AWHONN nurse staffing research team. DESIGN: Secondary analysis of responses to the 2010 AWHONN nurse staffing survey. SETTING: Online. PARTICIPANTS: AWHONN members (N = 884). METHODS: Review of data from an online survey of AWHONN members through the use of thematic analysis for descriptions of the consequences of inadequate nurse staffing during the childbirth process. RESULTS: Three main themes emerged as consequences of inadequate staffing or being short-staffed: Missed Care, Potential for Failure to Rescue, and Job-Related Stress and Dissatisfaction. These themes are consistent with those previously identified in the literature related to inadequate nurse staffing. CONCLUSION: Based on the responses from participants in the 2010 AWHONN nurse staffing survey, consequences of inadequate staffing can be quite serious and may put patients at risk for preventable harm.

What Do Childbearing Women in Your Clinical Practice Look Like?

With cultural diversity increasing, what do the childbearing women in your practice look like? Beliefs about the central role of motherhood and the use of fertility rites in the life of a woman vary. Although individual differences exist because of the uniqueness of each woman, there are wonderfully rich cultural traditions and practices that influence what a woman believes and enacts. What constitutes a satisfying birth experience varies from woman to woman. Perinatal nurses can find many satisfying clinical experiences by being creative, flexible, and resilient in their approach to providing care.

A Nurse's Guide to Supporting Physiologic Birth.

Physiologic birth promotes the practice of normal labor and birth, in which a woman's innate power is supported and unnecessary interventions are avoided. Nurses are in a unique position to support physiologic birth because they attend almost all births. Several resources are available to assist nurses in promoting physiologic birth, including BirthTOOLS.org, a new online resource developed by the American College of Nurse-Midwives in collaboration with other organizations. By using resources such as BirthTOOLS.org and others, nurses can become familiar with the evidence surrounding physiologic birth and can contribute to improved patient safety and quality of care by supporting physiologic birth. http://dx.doi.org/10.1016/j.nwh.2015.12.009.

Preventing Workplace Injuries Among Perinatal Nurses.

Many aspects of perinatal nursing put nurses at risk for injuries, including frequent repetitive bending, lifting of clients, and exposure to potentially large amounts of body fluids such as blood and amniotic fluid. Violence is also a potential risk with stressful family situations that may arise around childbirth. Workplace injuries put a health care facility at risk for staff turnover, decreases in the number of skilled nurses, client dissatisfaction, workers' compensation payouts, and employee lawsuits. Through the use of safety equipment, improved safety and violence training programs, "no manual lift" policies, reinforcement of personal protective equipment usage, and diligent staff training to improve awareness, these risks can be minimized.

Does use of computer technology for perinatal data collection influence data quality?

Population health data, collected worldwide in an effort to monitor mortality and morbidity of mothers and babies, namely, perinatal data, are mandated at a federal level within Australia. The data are used to monitor patterns in midwifery, obstetric and neonatal practice, health outcomes, used for research purposes, funding allocation and education. Accuracy in perinatal data is most often reported via quantitative validation studies of perinatal data collections both internationally and in Australia. These studies report varying levels of accuracy and suggest researchers need to be more aware of the quality of data they use. This article presents findings regarding issues of concern identified by midwives relating to their perceptions of how technology affects the accuracy of perinatal data records. Perinatal data records are perceived to be more complete when completed electronically. However, issues regarding system functionality, the inconsistent use of terminology, lack of data standards and the absence of clear, written records contribute to midwives' perceptions of the negative influence of technology on the quality of perinatal data.

Women's Satisfaction With Obstetric Triage Services.

OBJECTIVE: To determine the satisfaction of pregnant women who presented at a triage unit in an obstetric birthing care unit with obstetric triage services. DESIGN: Qualitative descriptive with conventional content analysis. SETTING: Individual audio recorded telephone interviews with women after discharge from a tertiary care hospital's obstetric triage unit. PARTICIPANTS: Purposive sample of 19 pregnant women who had received obstetric triage services. METHODS: A semi-structured interview guide was used for data collection. All interviews were audio-taped and transcribed verbatim. Data analysis was consistent with qualitative content analysis with open coding to categorize and develop themes to describe women's satisfaction with triage services and care. RESULTS: Five themes, Triage Unit Environment, Triage Staff Attitude and Behavior, Triage Team Function, Nursing Care Received in Triage and Time Spent in Triage, illustrated the women's recent triage experiences. Overall the women were very satisfied with the triage services. Women appreciated a caring approach from triage nurses, being informed about the well-being of themselves and their fetuses, being closely monitored, and effective teamwork among the members of the health care team. CONCLUSIONS: The results indicated that a humanizing, caring approach by the inter-professional team offering obstetric triage services contributed to women's satisfaction and woman-centered care.

Predicting nurse staffing needs for a labor and birth unit in a large-volume perinatal service.

This project was designed to test a nurse staffing model for its ability to accurately determine staffing needs for a large-volume labor and birth unit based on a staffing gap analysis using the nurse staffing guidelines from the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN). The staffing model and the AWHONN staffing guidelines were found to be reliable methods to predict staffing needs for a large-volume labor and birth unit.

Developing a process to support perinatal nurses after a critical event.

The work of perinatal nurses sometimes includes emergencies involving death, or near death, which can leave health care providers with feelings of stress and grief. After experiencing a particularly stressful period, nurses at our organization identified processes to help themselves recover and to support each other. The result of this work is a written plan to facilitate the support of perinatal nurses after critical events. This article describes the development and implementation of this plan.