Atendimento do parto sob um modelo obstétrico de trinômio, seu significado a partir do ponto de vista de casais / Atención de parto bajo un modelo obstétrico de trinomio su significado en visión de parejas / Childbirth care under a trinomial obstetric model, its meaning from the couple's point of view

Objetivo: interpretar o significado do acompanhamento do pai durante o atendimento perinatal. Metodologia: pesquisa qualitativa, descritiva, sustentada pela teoria das representações sociais; participaram 34 casais, selecionados por terem sido atendidos durante toda a etapa perinatal; coleta de dados mediante entrevista, a análise dos dados efetuou-se sob um marco interpretativo, mediante técnica cromática, os resultados são discutidos com base nas representações sociais de Moscovici, conceitualizando a categoria; confronta-se o dado empírico com a teoria, para expressar o raciocínio lógico. Resultados: percepção da participação do pai e significado do acompanhamento deste no atendimento, tipo de experiência obtida, conscientização do esposo no atendimento ao neonato, destacou-se o papel do pai no atendimento perinatal integral, demonstrando sua intervenção como parte do trinômio. Conclusão: O significado que a mãe expressa na participação do pai durante o parto é a relevância de sua presença.

Objetivo: interpretar el significado de acompañamiento del padre durante la atención perinatal. Metodología: investigación cualitativa, descriptiva, sustentada por la teoría de representaciones sociales; participaron 34 parejas, seleccionadas por haber sido atendidas durante toda la etapa perinatal; colecta de datos mediante entrevista, se efectúa el análisis de datos bajo un marco interpretativo, mediante técnica cromática, los resultados se discuten con base en representaciones sociales de Moscovici, conceptualizando la categoría; se confronta el dato empírico con la teoría, así plasmar el razonamiento lógico. Resultados: percepción de participación del padre y significado del acompañamiento de este en la atención, tipo de experiencia obtenida, concientización del esposo en la atención del neonato, destacar el rol del padre en la atención perinatal integral, patentizar su intervención como parte del trinomio. Conclusión: el significado que la madre manifiesta de la participación del padre durante el periodo del parto es la relevancia de su presencia.

Objective: to interpret the meaning of accompaniment of the father during the perinatal care. Method: qualitative, descriptive research, supported by the theory of social representations; 34 couples participated, selected for having been cared for throughout the perinatal care; data collection through interview, data analysis was carried out under an interpretive framework, using a chromatic technique, the results are discussed based on Moscovici's social representations, conceptualizing the category; the empirical data is confronted with the theory, thus capturing the logical reasoning. Results: perception of the father's participation and meaning of his accompaniment in the care, type of experience obtained, awareness of the husband in the care of the newborn, highlight the role of the father in comprehensive perinatal care, demonstrate his intervention as part of the trinomial. Conclusion: the mother reveals about the meaning of the father's participation during the delivery period the relevance of her presence

A vivência do pai no nascimento por cesariana no centro obstétrico: contribuições para a assistência / The father's experience in cesarean birth at the obstetric center: contributions to care / La experiencia del padre al nacimento por cesárea en el centro obstétrico: contribuciones a la asistencia

Objective: the study's goal has been to describe the experience of the accompanying father in the birth process by caesarean section at the Obstetric Center and point out the favorable and unfavorable conditions that influence this process.Methods: qualitative research, carried out at a University Hospital from august to september 2016 with 10 accompanying parents. The data collection was established by a semi-structured interview, submitted to Bardin's content analysis. Results: through the analysis, two categories emerged: possibilities and limitations in the experience of accompanying parents and emotional aspects in the birth process, which include the physical aspects of the operating room, the welcoming and guidance of the multidisciplinary team and the feelings presented by the parents. Conclusion: the father's participation in the cesarean delivery provides positive impacts for the mother-child-family trinomial, making crucial his presence since prenatal care and the physical adequacy of the cesarean environment

Objetivo: descrever a vivência do pai acompanhante no processo de nascimento por cesariana no Centro Obstétrico e apontar as condições favoráveis e desfavoráveis que influenciaram neste processo. Métodos: pesquisa qualitativa, realizada em um Hospital Universitário de agosto a setembro de 2016 com 10 pais acompanhantes. A coleta de dados se estabeleceu por meio de uma entrevista semiestruturada, submetida à análise de conteúdo de Bardin. Resultados: pela análise, emergiram duas categorias: possibilidades e limitações na vivência do pai acompanhante e aspectos emocionais no processo de nascimento, que compreenderam: os aspectos físicos da sala de cirurgia, o acolhimento e orientação da equipe multiprofissional e os sentimentos apresentados pelos pais. Conclusão: a participação do pai no parto cesárea proporciona impactos positivos ao trinômio mãe-filho-família, tornando cruciais a sua presença desde o pré-natal e a adequação física do ambiente da cesárea

Objetivo: describir la experiencia del padre acompañante en el proceso de parto por cesárea en el Centro de Obstetricia y señalar las condiciones favorables y desfavorables que influyeron en este proceso. Métodos: investigación cualitativa realizada en un Hospital Universitario de agosto a septiembre de 2016 con 10 padres acompañantes. La recopilación de datos se estableció mediante una entrevista semiestructurada, sometida al análisis del contenido de Bardin. Resultados: por análisis, surgieron dos categorías: posibilidades y limitaciones en la experiencia del padre acompañante y aspectos emocionales en el proceso del parto, que incluyeron los aspectos físicos de la sala de operaciones, la bienvenida y la orientación del equipo multidisciplinario y los sentimientos presentados por los padres. Conclusión: la participación del padre en la cesárea proporciona impactos positivos para el trinomio madre-hijo-familia, lo que hace que su presencia desde la atención prenatal y la adecuación física del entorno de la cesárea sean cruciales

Identifying optimal labor and delivery nurse staffing: The case of cesarean births and nursing hours.

BACKGROUND: Numerous studies have identified a relationship between nurse staffing and adverse patient outcomes in medical / surgical patient populations. However, little is known about the impact of labor and delivery (L&D) nurse staffing and adverse birth outcomes, such as unintended cesarean delivery, in low-risk term-gestation women. PURPOSE: We examined nurse staffing patterns on the likelihood of cesarean sections (C-sections) among low- risk, full gestation births and provided a testing framework to distinguish optimal from ineffective levels of nurse staffing. METHODS: This retrospective descriptive study used hours of productive nursing time per delivery as the treatment variable to determine direct nursing time per delivery and its impact on the likelihood of a C-section. For comparisons, we also assessed the likelihood of augmentations and of inductions, as well as the number of neonatal intensive care unit (NICU) hours per birth. We limited our sample to those births between 37 and 42 weeks of gestation. Two complimentary models (the quadratic and piecewise regressions) distinguishing optimal staffing patterns from ineffective staffing patterns were developed. The study was implemented in eleven hospitals that are part of a large, integrated healthcare system in the Southwest. DISCUSSION: While a simple linear regression of the likelihood of a C-section on nursing hours per delivery indicated no statistically distinguishable effect, our 'optimal staffing' model indicated that nurse staffing hours employed by using a large sample of hospitals were actually minimizing C-sections (robustness checks are provided using similar model comparisons for the likelihood of augmentation and induction, and NICU hours). Where the optimal staffing models did not appear to be effective for augmentations, inductions, and NICU hours, we found significant differences between facilities (i.e., significant fixed effects for hospitals). In all specifications, we also controlled for weeks of gestation, race, sex of the child, and mother's age.

Meaningful learning actualized through a perinatal continuity of care experience.

Leaders in nursing education embrace innovative, real-world learning environments that transform today's generation of nursing students into critical thinkers. Scheduling exclusive child-bearing practicums are challenging due to staffing, time, and maternal client presentation. Utilizing transformative learning theory a perinatal continuum of care clinical learning experience evolved. This paper will discuss the qualitative, descriptive study of Bachelor of Science in Nursing students in rural, Midwestern United States who completed maternal/infant didactic, high-fidelity simulation, and real-world experiences relative to women during the perinatal period. Participants (n = 50) consisted of third-semester baccalaureate nursing students enrolled in the maternal/infant course. Data were collected from students' reflective journal blogs at the end of the semester. The aim of this study was to identify the outcomes of students learning through this perinatal experience. Three themes emerged from this study: self-analysis, critical thinking, and self-efficacy. Students' reflection indicated that through this comprehensive clinical experience, they developed a new self-awareness. Students noted that the experience was unique to any they had encountered. The perinatal assignment provided an opportunity for professional growth in this specialty area due to the interface of theory, simulation, and clinical applications expounded in the reflective clinical blog throughout the experience.

Prevalência de parto vaginal após cesárea em uma maternidade de alto risco / Prevalence of vaginal delivery after cesarean in a high-risk maternity / Prevalencia de entrega vaginal después de cesárea en una maternidad de alto riesgo

Objetivo: estimar a prevalência de parto vaginal após cesárea em uma maternidade de alto risco e identificar as complicações maternas e neonatais. Método: trata-se de um estudo transversal, quantitativo e retrospectivo, realizado com 44 mulheres que tiveram parto normal com cesárea prévia, por meio da análise dos prontuários realizou-se a análise descritiva com frequências absolutas e simples. Resultados: a prevalência de parto vaginal após cesárea foi de 13%. Ocorreu complicação em 13,6% das mulheres, porém não houve rotura uterina e em 4,5% dos neonatos. Conclusões: os desfechos favoráveis comprovam a segurança deste procedimento para a mãe e para neonato e servem de estímulo para que os profissionais incentivem as gestantes com cesárea anterior a considerarem a via vaginal como uma possibilidade segura para o próximo parto

Objective: to estimate the prevalence of vaginal delivery after cesarean section in a high-risk maternity and to identify maternal and neonatal complications. Method: this is a cross-sectional, quantitative and retrospective study, carried out with 44 women who had a normal delivery with previous cesarean section, through the analysis of medical records, descriptive analysis was carried out with absolute and simple frequencies. Results: the prevalence of vaginal delivery after cesarean section was 13%. Complication occurred in 13.6% of women, but there was no uterine rupture and in 4.5% of neonates. Conclusions: the favorable outcomes prove the safety of this procedure for the mother and the newborn and serve as a stimulus for professionals to encourage pregnant women with a previous cesarean to consider the vaginal route as a safe possibility for the next delivery

Objetivo: estimar la prevalencia del parto vaginal después de una cesárea en una maternidad de alto riesgo e identificar complicaciones maternas y neonatales. Método: se trata de un estudio transversal, cuantitativo y retrospectivo, realizado con 44 mujeres que tuvieron un parto normal con cesárea previa, a través del análisis de registros médicos, se realizó un análisis descriptivo con frecuencias absolutas y simples. Resultados:la prevalencia del parto vaginal después de una cesárea fue del 13%. La complicación ocurrió en el 13.6% de las mujeres, pero no hubo ruptura uterina y en el 4.5% de los recién nacidos. Conclusiones: los resultados favorables demuestran la seguridad de este procedimiento para la madre y el recién nacido y sirven de estímulo para que los profesionales alienten a las mujeres embarazadas con una cesárea previa a considerar la vía vaginal como una posibilidad segura para el próximo parto

A concept analysis of obstetric violence in the United States of America.

The aim is to clarify the concept of "obstetric violence in the United States of America." Obstetric violence (OV) is a poorly defined and rarely applied concept in the United States that causes significant harm and requires recognition. The design is a concept analysis to examine the structure and function of OV in the United States. An English language literature review with no date restrictions was performed using CINAHL, PubMed, and Google search. The search was expanded to the related terms "birth rape" and "birth trauma." The concept analysis was conducted using the method outlined by Walker and Avant. The synthesized definition proposed is: Obstetric violence is abuse or mistreatment by a health care provider of a female who is engaged in fertility treatment, preconception care, pregnant, birthing, or postpartum; or the performance of any invasive or surgical procedure during the full span of the childbearing continuum without informed consent, that is coerced, or in violation of refusal. It is a sex-specific form of violence against women (VAW) that is a violation of human rights. A clear definition and understanding of OV in the United States will allow for its recognition. A conceptual basis for naming it can lead to better knowing its prevalence, further studies, and operationalizing the term to create pathways for accountability and restitution. Nurses are in a unique position to minimize OV risk and to promote individual and unit-based responses for zero-tolerance.

Cervical Ripening and Labor Induction and Augmentation, 5th Edition.

Cervical ripening and induction and augmentation of labor are common procedures in labor and birth units. The potential risks and benefits for the procedure should be explained to women so that they can make informed decisions. Clinicians should be knowledgeable about the methods and medications used and be skilled in maternal-fetal assessment. Adequate nurse staffing is required to monitor the mother and fetus to promote the best possible outcomes. This practice monograph includes information on mechanical and pharmacologic methods for cervical ripening; labor induction and augmentation with oxytocin, a high alert drug; and nurse staffing levels and skills needed to provide safe and effective care during cervical ripening and labor induction and augmentation.

Evaluation of a nursing and midwifery exchange between rural and metropolitan hospitals: A mixed methods study.

INTRODUCTION: This paper reports on the findings of the Nursing and Midwifery Exchange Program, initiated to promote rural and remote nursing and midwifery, and to facilitate clinical skills development and clinical collaboration between health services in Queensland, Australia. The project was undertaken over an 18-month period in one state of Australia, offering structured, temporary exchange of personnel between metropolitan and rural health services. BACKGROUND: Globally, there is an increasing awareness of nursing shortages, and with it, the need to ensure that nurses and midwives are prepared for specialist roles and practice. This is particularly important in rural and remote areas, where there are pre-existing barriers to access to services, and difficulties in attracting suitably qualified, permanent staff. METHODS: A mixed methods approach to the evaluation was undertaken with two cohorts. One cohort was the nurses and midwives who participated in the exchange (n = 24) and the other cohort were managers of the participating health services (n = 10). The nurses and midwives who participated in the exchange were asked to complete a questionnaire that included questions related to embeddedness and job satisfaction. The managers participated in a Delphi series of interviews. RESULTS: Those who participated in exchange reporting a higher score on the reported degree of understanding of rural client, which was accompanied with a moderate-to-large effect size estimate (d = 0.61). Nurses/midwives in the exchange group reported higher scores on their perceptions of aspects of their home community that would be lost if they had to leave, which was accompanied with a large effect size (d = 0.83). Overall, NMEP was reported by the participants to be a positive way to improve professional development opportunities for nurses and midwives. The findings also show the program supported practical collaboration and raised the profile of nursing and midwifery in rural areas. CONCLUSION: Exchange programs support clinical and professional development, raising the awareness of different contexts of practice and related skills requirements, and thereby supporting a greater understanding of different nursing roles. In the light of increasingly complex care required by patients with chronic conditions being managed in community-based services, programs such as NMEP provide the opportunity to build collaborative networks between referring and referral centres as well as contribute to the ongoing skills development.

Nursing Support During Latent Phase Labor: A Scoping Review.

PURPOSE: The purpose of this scoping review was to synthesize the literature on nursing support during the latent phase of the first stage of labor. In 2014, the definition of the beginning of active labor changed from 4 centimeters (cm) to 6 cm cervical dilation. More women may have an induction of labor based on results of recent research showing no causal increase in risk of cesarean birth with elective induction of labor for low-risk nulliparous women. Therefore, in-hospital latent phase labor may be longer, increasing the need for nursing support. DESIGN: Scoping review of the literature from 2009 to present. METHODS: We conducted the review using key words in PubMed, CINAHL, and Scopus. Search terms included different combinations of "latent or early labor," "birth," "support," "nursing support," "obstetrics," and "onset of labor." Peer-reviewed research and quality improvement articles from 2009 to present were included if they had specific implications for nursing care during the latent phase of labor. Articles were excluded if they were not specific to nursing, focused exclusively on tool development, or were from the perspective of pregnant women or providers only. RESULTS: Ten articles were included. Results were synthesized into six categories; support of physiologic labor and birth, the nurse's own personal view of labor, birth environment, techniques and tools, decision-making, and importance of latent labor discussion during the prenatal period. CLINICAL IMPLICATIONS: Support for physiologic labor and birth is an important consideration for use of nonpharmacological methods during latent labor. The nurse's own personal view on labor support can influence the support that laboring women receive. Nurses may need additional education on labor support methods.

Curso de aprimoramento para enfermeiras obstétricas do Projeto Apice On: relato de experiência / Curso de perfeccionamiento para enfermeras obstétricas del Proyecto Apice On: relato de experiencia / Improvement course for obstetric nurses of the Apice On Project: an experience report

Resumo Objetivo relatar as experiências práticas vivenciadas no Curso de Aprimoramento para Enfermeiros Obstetras do projeto Apice On do Ministério da Saúde. Método estudo descritivo na modalidade relato de experiência. Os relatos foram colhidos a partir de uma pergunta norteadora em um encontro virtual das autoras. Resultados as reflexões foram agrupadas em duas principais temáticas: 1) O potencial da Enfermagem Obstétrica e 2) O cuidado como elemento principal da assistência. Conclusão e Implicações para a prática o curso é uma estratégia nacional de grande impacto para o empoderamento e visibilidade da categoria profissional da Enfermagem Obstétrica. O aprimoramento possibilitou, às enfermeiras participantes, a aquisição de habilidades práticas e segurança técnica, além de motivá-las à construção de estratégias para a superação dos modelos obstétricos que não estão alinhados às atuais recomendações científicas.

Resumen Objetivo reportar las experiencias prácticas vividas en el Curso de Mejoramiento para Enfermeras Obstétricas del proyecto Apice On del Ministerio de Salud. Método estudio descriptivo en la modalidad de informe de experiencia. Los informes se recopilaron de una pregunta orientadora en una reunión virtual de los autores. Resultados las reflexiones se agruparon en dos temas principales: 1) El potencial de la enfermería obstétrica y 2) El cuidado como elemento principal de la atención. Conclusión e Implicaciones para la Práctica el curso es una estrategia nacional de gran impacto para el empoderamiento y la visibilidad de la categoría profesional de Enfermería Obstétrica. La mejora permitió a las enfermeras participantes adquirir habilidades prácticas y seguridad técnica, y motivarlas a desarrollar estrategias para superar los modelos obstétricos que no están en línea con las recomendaciones científicas actuales.

Abstract Objective to report the practical experience lived in the Obstetric Nurses Improvement Course of the Apice On project of the Ministry of Health. Method descriptive study in the experience report modality. The reports were collected from a guiding question in a virtual meeting of the authors. Results the reflections were grouped into two main themes: 1) The potential of obstetric nursing and 2) Care as the main element of care. Conclusion an and Implications for practice the course is a national strategy of great impact for empowerment visibility of the professional category of Obstetrical Nursing. The improvement enable the participating nurses to acquire practical skills and technical safety, and motivate them to build strategies to overcome obstetric models that are not in line with current scientific recommendations.

Obstetric Nursing in best practices of labor and delivery care.

OBJECTIVE: to evaluate the association of Obstetric Nursing in the best practices of delivery and birth care in maternity hospitals. METHOD: a cross-sectional study, with 666 women selected for delivery. Parturition obstetric practices performed by professionals were categorized into: clearly useful practices that should be encouraged, practices that are clearly harmful or ineffective and that should be eliminated and practices used inappropriately at the time of parturition. RESULTS: clearly useful practices were used in greater proportions in the hospitals that had Obstetric Nursing working, while clearly harmful practices and those used inappropriately were practiced in smaller proportions in hospitals that had Obstetric Nursing, both with statistical difference. CONCLUSION: institutions with Obstetric Nursing adopt better practices of delivery and birth care, based on scientific evidence, when compared to those that do not act.

Nurses- puerperal mothers interaction: searching for cultural care.

OBJECTIVE: To identify the importance of the cultural care dimension in the nurse-puerperal mother interaction. METHOD: Qualitative study based on content analysis. To collect data, 36 semi structured interviews were applied (21 nurses and 15 women who had recently given birth). The participants' free and informed consent was ensured and all ethical requirements were respected. Data analysis was supported by NVivo 10 software. RESULTS: The following categories were considered the most relevant: (i) nurses' attitudes that puerperal mothers consider crucial in health care provision; (ii) nurses' cultural competence; (iii) language resources used by nurses in their interaction with people from other cultures; (iv) the limitations that were observed during nurses-new mothers interactions. CONCLUSION: Evidence shows that, generally speaking, nurses claim to provide personalized health care assistance. However data revealed that the kind of interaction observed between nurses and women who had just given birth has not always been the most effective and that the former often show they lacked the appropriate cultural competence to deal with the latter's expectations and needs.

Nurses- puerperal mothers interaction: searching for cultural care / Interacción enfermeras y madres: en la búsqueda de un cuidado cultural / Interação enfermeiros e puérperas: na procura de um cuidado cultural

ABSTRACT Objective: To identify the importance of the cultural care dimension in the nurse-puerperal mother interaction. Method: Qualitative study based on content analysis. To collect data, 36 semi structured interviews were applied (21 nurses and 15 women who had recently given birth). The participants' free and informed consent was ensured and all ethical requirements were respected. Data analysis was supported by NVivo 10 software. Results: The following categories were considered the most relevant: (i) nurses' attitudes that puerperal mothers consider crucial in health care provision; (ii) nurses' cultural competence; (iii) language resources used by nurses in their interaction with people from other cultures; (iv) the limitations that were observed during nurses-new mothers interactions. Conclusion: Evidence shows that, generally speaking, nurses claim to provide personalized health care assistance. However data revealed that the kind of interaction observed between nurses and women who had just given birth has not always been the most effective and that the former often show they lacked the appropriate cultural competence to deal with the latter's expectations and needs.

RESUMEN Objetivo: identificar la dimensión de la competencia cultural en la interacción entre enfermeras y mujeres que hayan dado a luz recientemente. Método: estudio cualitativo basado en el análisis de contenidos. En la recopilación de datos se utilizó la entrevista semiestructurada. Han participado 21 enfermeras y 15 madres en un total de 36 entrevistas. Se aseguró el consentimiento previo, libre e informado de todos los participantes y todos los requisitos éticos fueron respetados. El análisis de datos fue apoyado por el programa NVivo 10. Resultados: las siguientes categorías fueron destacadas: (i) actitudes de las enfermeras que las madres creen ser indispensables en el proceso de cuidar; ii) el ejercicio de la competencia cultural; iii) los recursos lingüísticos utilizados por las enfermeras en la interacción con personas de otras culturas; iv) restricciones y problemas observados en las interacciones entre enfermeras y madres. Conclusión: se concluye que, en general, las enfermeras afirman que cuidan de sus pacientes de manera personalizada. Todavía, los datos revelaron que las interacciones entre enfermeras y madres son a menudo poco eficaces y a las enfermeras les resulta difícil demostrar su competencia cultural.

RESUMO Objetivo: Identificar a dimensão do cuidado cultural na interação entre enfermeiras e puérperas. Método: Estudo qualitativo assente na análise de conteúdo. Na colheita de dados se utilizou a entrevista semiestruturada, a 21 enfermeiras e 15 puérperas num total de 36 entrevistadas. Se assegurou o consentimento livre e esclarecido bem como respeitaram-se todos os requisitos éticos. A análise de dados foi suportada pelo NVivo 10. Resultados: Destacaram-se as categorias: (i) Atitudes das enfermeiras que as puérperas reconhecem imprescindíveis no processo de cuidar; (ii) Exercitar a competência cultural; (iii) Recursos linguísticos utilizados pelas enfermeiras na interação com pessoas de outras culturas; (iv) Constrangimentos manifestados nas interações enfermeiras e puérperas. Conclusão: Conclui-se que apesar das enfermeiras, ao nível discursivo, afirmarem que cuidam de forma personalizada, os dados revelaram que nem sempre as enfermeiras foram eficazes nas interações com as puérperas, de forma a demonstrarem a competência cultural, num estadio considerado culturalmente consciente.

Trust Your Wings and Not the Branch.

A nurse manager grapples with the closure of her obstetric unit.

Análise do preenchimento do partograma como boa prática obstétrica na monitorização do trabalho de parto / Analysis of partogram completion as good obstetric practice in the monitoring of labor / Análisis del llenado del partograma como buena práctica obstétrica en la monitorización del trabajo de parto

Objetivo: Analizar el llenado del partograma realizado por profesionales que prestan asistencia al trabajo de parto en un hospital escolar referencia materno-infantil del Valle del São Francisco. Métodos: Se trata de un estudio descriptivo documental, retrospectivo y transversal de abordaje cuantitativo realizado por medio del análisis de 191 prontuarios de parturientas asistidas en la Institución en el año 2015. Los datos fueron analizados en el SPSS versión 20. Resultados: Mostraron que sólo 40, El 6% de los prontuarios tenían registro de apertura del partograma, el análisis de las variables verificadas en el momento de la apertura del partograma permitió identificar que el 99,5% se inició en la fase activa del trabajo de parto. A pesar de un buen registro en su apertura, los datos muestran que el proceso de monitoreo del trabajo de parto aún es poco eficaz, pues el 59,2% tuvo apenas un solo registro. Conclusión: la utilización del partograma como una buena práctica obstétrica todavía es poco utilizada en esta maternidad, se hace necesario considerar su registro como una herramienta en el monitoreo del trabajo de parto para promover una asistencia adecuada como recomienda el Ministerio de Salud

Objective: Analyzing the partograph filling performed by professionals who provide assistance to the labor in a teaching hospital that is a maternal and child healthcare reference in the Vale do São Francisco. Methods: This is a descriptive, retrospective and transversal study with a quantitative approach. There were analyzed 191 medical records of assisted mothers in the institution during the year 2015. The data were analyzed in SPSS program version 20. Results: The results showed that only 40.6% of patient records had a record of parturition, and the analysis of the variables verified at the time of the start of the partogram identified that 99.5% of the records were started in the active phase of labor. Despite of a good record in the start of partograph, the data show that the process of monitoring of labor is still not veryeffective, because 59.2% of the partographs had only a single record. Conclusion: The use of partograph as a good obstetric practice is still little used in this maternity, it is necessary to consider the partogram registration as a tool in the monitoring of labor to promote adequate assistance as it is recommended by the Brazilian Ministry of Health

Objetivo: Analisar o preenchimento do partograma realizado por profissionais que prestam assistência ao trabalho de parto em um hospital escola referência materno infantil do Vale do São Francisco. Método: Tratase de um estudo descritivo documental, retrospectivo e transversal de abordagem quantitativa realizada por meio da análise de 191 prontuários de parturientes assistidas na Instituição no ano de 2015. Os dados foram analisados no SPSS versão 20. Resultados: Mostraram que apenas 40,6% dos prontuários tinham registro de abertura do partograma. A análise das variáveis verificadas no momento da abertura do partograma permitiu identificar que 99,5% foram iniciados na fase ativa do trabalho de parto. Apesar de um bom registro na sua abertura, os dados mostram que o processo de monitoramento do trabalho de parto ainda é pouco eficaz, pois 59,2% tiveram apenas um único registro. Conclusão: A utilização do partograma como uma boa prática obstétrica ainda é pouco utilizada nesta maternidade; faz-se necessário considerar seu registro como uma ferramenta no monitoramento do trabalho de parto para promover uma assistência adequada como recomenda o Ministério da Saúde

Association between non-invasive nursing care technologies during childbirth and neonatal vitality: a cross-sectional study / Asociación entre tecnologías no-invasivas de cuidado en el parto y la vitalidad neonatal: estudio transversal / Associação entre tecnologias não invasivas de cuidado no parto e vitalidade do recém-nascido: estudo transversal

Abstract Objective: to compare the use of non-invasive midwifery care technologies (TNICEO) with the use of traditional care model practices, having as parameters the presence of meconium in the amniotic fluid and its repercussion on the newborn's vitality. Method: a cross-sectional study with secondary data of 10,219 parturients who delivered by midwives between September 2004 and October 2016. Logistic regression was used to assess Apgar> 8 Odds Ratio in exposure to noninvasive midwifery care technologies when compared to traditional care. Results: there were higher percentages of light amniotic fluid and neonates with good vitality in parturients who used only TNICEO compared with those exposed only to traditional care. Conclusion: nurse midwives' provision of TNICEO and its use by women are efficient strategies to reduce unfavorable neonatal outcomes. Implications of practice: investments in the performance of these experts is important, as their know-how to make them not medicalized through TNICEO confirms a process of humanized, safe and quality care that meets official recommendations and contributes to the change in the care model.

Resumen Objetivo: comparar el uso de tecnologías no invasivas de cuidado de enfermería obstétrica (TNICEO) con el uso de prácticas del modelo tradicional de cuidado, con la presencia de meconio en el líquido amniótico y su repercusión en la vitalidad del recién nacido. Método: estudio transversal, com datos secundários, de 10.219 parturientas, asistidas por enfermeras obstétricas entre septiembre de 2004 y octubre de 2016. Se utilizó la regresión logística para evaluar la probabilidad de Apgar> 8 en la exposición a TNICEO en comparación con la atención tradicional. Resultados: se observaron porcentajes más altos de líquido amniótico claro y recién nacido con buena vitalidad en las parturientas que solo usaron TNICEO en comparación con las expuestas solo a la atención tradicional. Conclusión: la oferta de TNICEO por las enfermeras obstétricas y su uso por las mujeres es una estrategia eficaz para reducir los resultados neonatales desfavorables. Implicaciones para la práctica: enfatizase la importancia de los investimentos en el desempeño de estos especialistas, ya que su experiencia, a través del TNICEO, constituye un proceso de atención humanizada, segura y de alta calidad, que cumple con las recomendaciones oficiales y contribuye para cambiar el modelo de atención.

Resumo Objetivo: comparar o uso de tecnologias não invasivas de cuidado de enfermagem obstétrica (TNICEO) com o emprego de práticas do modelo de assistência tradicional, tendo como parâmetros a presença de mecônio no líquido amniótico e sua repercussão sobre a vitalidade do recém-nascido. Método: estudo transversal, com dados secundários, de 10.219 parturientes que tiveram parto acompanhado por enfermeiras obstétricas entre setembro/2004 e outubro/2016. Utilizou-se a regressão logística para avaliar a chance de Apgar >8 na exposição às tecnologias não invasivas de cuidado de enfermagem obstétrica quando comparada à assistência tradicional. Resultados: constataram-se maiores percentuais de líquido amniótico claro e neonatos com boa vitalidade nas parturientes que utilizaram somente TNICEO, em comparação com aquelas expostas, apenas, à assistência tradicional. Conclusão: o oferecimento das TNICEO pelas enfermeiras obstétricas e o seu uso pelas mulheres se configuram como estratégias eficientes para reduzir desfechos neonatais desfavoráveis. Implicações para a prática: destaca-se a importância de investimentos na atuação dessas especialistas, pois seu saber fazer desmedicalizado, por meio das TNICEO, confirma um processo de cuidar humanizado, seguro e de qualidade, que atende às recomendações oficiais e contribui para a mudança do modelo assistencial.