Intervención educacional para la mejora en la asistencia al trabajo de parto normal / Educational intervention to improve normal childbirth care / Intervenção educacional para melhoria na assistência ao trabalho de parto normal

INTRODUCCIÓN: El desempeño de la enfermería obstétrica en el escenario del parto y el parto, ha ido ganando protagonismo por ser una profesional considerada una figura indispensable para el logro de un parto humanizado, con el objetivo de rescatar la autonomía de las mujeres. MATERIALES Y MÉTODOS: Este es un estudio cuasi experimental, antes y después, que desarrolló una intervención educativa, realizada a través de un curso de capacitación aplicado al personal de enfermería. Celebrada del 01 al 03 de agosto de 2018 en la sala de partos de un hospital de maternidad en Teresina-PI. Se solicitó la autorización del comité de enseñanza e investigación de la institución, con una opinión favorable para llevar a cabo. RESULTADOS: Treinta y dos profesionales participaron en la intervención, con la mayoría del personal de enfermería del centro obstétrico, con 87.50% de técnicos de enfermería y 85.71% de enfermeras obstétricas. Se puede observar que en la prueba previa hubo un mayor número de errores en las preguntas, 5 con 46.87% de error y 10 con 32.50% de error en el tema de cuidados de enfermería en trabajo de parto y parto, con mejoría después de la aplicación de la intervención con 18.75 y 9.25 errores respectivamente en el examen posterior. DISCUSIÓN: Frente a varias opciones de estrategias de instrucción, la educación continua tiene un lugar destacado en enfermería, porque a partir de los resultados, podemos ver la mejora del conocimiento de profesionales después de aplicar la intervención educativa. CONCLUSIÓN: La intervención permitió a los profesionales ampliar sus conocimientos y proporcionar al binomio madre-RN una atención humanizada respaldada por evidencia científica

INTRODUCTION: The performance of obstetric nursing in the scenario of labor and childbirth has gained prominence because nursing professionals are considered indispensable actors for the achievement of humanized birth, to rescue the autonomy of women. MATERIALS AND METHODS: This is a quasi-experimental study of the before and after type, in which an educational intervention was developed, conducted through a training course applied to the nursing staff. The study was accomplished from August 01 to 03, 2018, in the childbirth room of a maternity hospital in Teresina-PI. Authorization from the teaching and research committee of the institution was requested, with a favorable Opinion for its realization. RESULTS: Thirty-two professionals participated in the intervention. The majority was from the obstetric center; 87.50% were nursing technicians and 85.71% obstetric nurses. There was a greater number of errors in questions 5 (46.87% of error) and 10 (32.50% of error) in the pre-test, in the theme nursing care in labor and childbirth, and an improvement of to 18.75 and 9.25 of error, respectively, in the post-test. DISCUSSION: Among the several options of instructional strategies, continuing education has a prominent place in nursing, as the results of this study showed an improvement in the knowledge of professionals after application of the educational intervention. CONCLUSION: The intervention allowed the professionals to broaden their knowledge and provide the mother-newborn binomial with a humanized care supported by scientific evidence

INTRODUÇÃO: A atuação da enfermagem obstétrica no cenário do trabalho de parto e parto vem ganhando destaque por esse ser um profissional considerado uma figura indispensável para o alcance de um parto humanizado, com intuito de resgatar a autonomia da mulher. MATERIAIS E MÉTODOS: Trata-se de um estudo quase experimental, do tipo antes e depois, o qual foi desenvolvido uma intervenção educacional, realizada por meio de curso de capacitação aplicado à equipe de enfermagem. Realizado no período de 01 a 03 de agosto de 2018 na sala de parto de uma maternidade em Teresina-PI. Solicitada autorização do comitê de ensino e pesquisa da instituição, com parecer favorável para realização. RESULTADOS: Participaram da intervenção 32 profissionais, havendo a presença majoritária da equipe de enfermagem do centro obstétrico, com a composição de 87,50% de técnicos de enfermagem e 85,71% de enfermeiros obstetras. Pode-se observar que no pré-teste houve maior número de erros nas questões 5 com 46,87% de erro e a 10 com 32,50% de erro da temática cuidados de enfermagem no trabalho de parto e parto, com melhoria após aplicação da intervenção com 18,75 e 9,25 de erros respectivamente no pós teste. DISCUSSÃO: Diante de diversas opções de estratégias instrutivas, a educação continuada possui um lugar de destaque na enfermagem, pois a partir dos resultados, podemos perceber a melhoria dos conhecimentos dos profissionais após aplicação da intervenção educativa. CONCLUSÃO: A intervenção possibilitou que os profissionais ampliassem seus conhecimentos e proporcionar ao binômio mãe-RN um cuidar humanizado e respaldado das evidências científicas

Midwives' perceptions of women's mobile phone use and impact on care in birth suite.

BACKGROUND: Women's use of mobile phones while in birth suite has been recognised as a common occurrence. However, no evidence has been reported around midwives' perceptions of how women's mobile phone use impacts midwifery care in birth suite. OBJECTIVE: To explore midwives' perceptions of women's mobile phone use and impact on care in the labour and birth environment. METHODS: A qualitative descriptive study was undertaken. Transcriptions from focus groups were subjected to thematic analysis. FINDINGS: Ten focus groups involving 63 Australian midwives were conducted. Four key themes and corresponding subthemes were identified: 'considering consent' which encompassed the subthemes 'establishing boundaries' and 'taken by surprise'; 'competing with the phone' encompassing 'missing the experience' and 'delaying care'; 'being with woman' encompassing 'affecting relationships' and 'not my right to deny'; and finally 'bringing others into the room' with subthemes of 'keeping in touch' and 'seeking a second opinion'. CONCLUSIONS: This is the first study to explore midwives perceptions of women's mobile phone use and the impact on a midwife's ability to provide care in birth suite. Findings suggest that women's mobile phone use can influence the relationship between the midwife and the woman and contributes to delays in providing care. Midwives shared how they experienced tensions around their right to grant permission for their image to be recorded. Finally, mobile phones have allowed others not present in the birth suite to access women and influence their decision making. IMPLICATIONS FOR PRACTICE: It is widely recognised women are bringing their mobile phones into the labour and birth environment. Therefore, it is important we explore midwives perceptions around the tensions and concerns that exist, so they can be addressed.

Outcomes by birth setting and caregiver for low risk women in Indonesia: a systematic literature review.

BACKGROUND: Care for women during pregnancy, labour, birth and the postpartum period is essential to reducing maternal and neonatal mortality and morbidity, however the ideal place and organisation of care provision has not been established. The World Health Organization recommends a two-tier maternity care system involving first-level care in community facilities, with backup obstetric hospital care. However, evidence from high-income countries is increasingly showing benefits for low risk women birthing outside of hospital with skilled birth assistance and access to backup care, including lower rates of intervention. Indonesia is a lower middle-income country with a network of village based midwives who attend births at homes, clinics and hospitals, and has reduced mortality rates in recent decades while maintaining largely low rates of intervention. However, the country has not met its neonatal or maternal mortality reduction goals, and it is unclear whether greater improvements could be made if all women birthed in hospital. BODY: This paper reviewed the literature on birth outcomes by place of birth and/or caregiver for women considering their risk of complications in Indonesia. A systematic literature search of Pubmed, CINAHL, CENTRAL, Web of Science, Popline, WHOLIS and clinical trials registers in 2016 and updated in 2018 resulted in screening 2211 studies after removing duplicates. Twenty four studies were found to present outcomes by place of birth or caregiver and were included. The studies were varied in their findings with respect of the outcomes for women birthing at home and in hospital, with and without skilled care. The quality of most studies was rated as poor or moderate using the Effective Public Health Practice Project Quality Assessment Tool. Only one study gave an overall assessment of the risk status of the women included, making it impossible to draw conclusions about outcomes for low risk women specifically; other studies adjusted for various individual risk factors. CONCLUSION: From the studies in this review, it is impossible to assess the outcomes for low risk women birthing with health professionals within and outside of Indonesian hospitals. This finding is supported by reviews from other countries with developing maternity systems. Better evidence and information is needed before determinations can be made about whether attended birth outside of hospitals is a safe option for low risk women outside of high income countries.