Impacto de la implementación de un método de traspaso de información estandarizada interdisciplinar en sala de partos y unidad de cuidados obstétricos intermedios / Impact of the implementation of a standardised interdisciplinary information transfer method in the Delivery room and Intermediate Obstetric Care Unit

Objetivo Este estudio tiene como objetivo describir la implementación de la metodología estandarizada en la transferencia de información en sala de partos y unidad de cuidados obstétricos intermedios en un hospital de tercer nivel de Barcelona e identificar el impacto de esta implementación en los factores que actúan como facilitadores y barreras en el procedimiento. Método Estudio cuasiexperimental tipo pretest-postest sin grupo control en la unidad de cuidados obstétricos intermedios y sala de partos del servicio de Medicina Maternofetal de un hospital de tercer nivel de Barcelona. El personal sanitario autocumplimentó un cuestionario ad hoc antes y después de implementar la metodología estandarizada IDEAS en el servicio durante 2019 y 2020. Se evaluó la autopercepción personal en el procedimiento de transferencia de información. El test de Wilcoxon por pares se utilizó para la comparación antes y después. Resultados El uso de una metodología estandarizada ha mostrado un impacto en la mejora de la transmisión de la información. Se detectaron diferencias significativas antes y después de la intervención en las siguientes dimensiones: ubicación, personas implicadas, periodo de tiempo del procedimiento, estructurada ordenada y clara y tiempo suficiente para preguntas (p<0,001); mientras que no se observaron diferencias en transmisión al profesional referente, actuaciones bien definidas y realización de un resumen. Conclusiones Existen factores, como aspectos estructurales, organizativos y falta de tiempo, que dificultan la comunicación efectiva, por tanto, actúan como barreras en la transferencia de información. La implementación de una metodología con las personas implicadas, el tiempo y el espacio adecuado permite mejorar aspectos en la comunicación en el equipo multiprofesional y, por tanto, la seguridad del paciente. (AU)

Aim This study aims to describe the implementation of the standard methodology for information transfer in the labour ward and Intermediate Obstetric Care Unit and to identify the impact of this implementation on the factors that act as facilitators and barriers in the procedure. Method Quasi-experimental pretest-posttest study without a control group in an Intermediate Obstetric Care Unit and delivery room of the Maternal-Fetal Medicine Service of a tertiary hospital in Barcelona. Healthcare staff self-completed an ad hoc questionnaire before and after implementing the standardised IDEAS methodology in the service during 2019 and 2020. Personal self-perception in the information transfer procedure was assessed. The Wilcoxon pairwise test was used for comparison before and after. Results The use of a standardised methodology has shown an impact on improving the transmission of information. Significant differences were detected before and after the intervention in the following dimensions: location, people involved, time period of the procedure, structured, orderly and clear, and sufficient time for questions (p<0.001); while no differences were observed in: transmission to the referring professional, well-defined actions, and completion of a summary. Conclusions There are factors such as structural and organisational aspects and lack of time that hinder effective communication and therefore act as barriers to the transfer of information. The implementation of a methodology with the health professionals involved, the time and the appropriate space allows for the improvement of communication aspects in the multiprofessional team and, therefore, patient safety. (AU)

Impacto de la implementación de un método de traspaso de información estandarizada interdisciplinar en sala de partos y unidad de cuidados obstétricos intermedios / Impact of the implementation of a standardised interdisciplinary information transfer method in the Delivery room and Intermediate Obstetric Care Unit

Objetivo Este estudio tiene como objetivo describir la implementación de la metodología estandarizada en la transferencia de información en sala de partos y unidad de cuidados obstétricos intermedios en un hospital de tercer nivel de Barcelona e identificar el impacto de esta implementación en los factores que actúan como facilitadores y barreras en el procedimiento. Método Estudio cuasiexperimental tipo pretest-postest sin grupo control en la unidad de cuidados obstétricos intermedios y sala de partos del servicio de Medicina Maternofetal de un hospital de tercer nivel de Barcelona. El personal sanitario autocumplimentó un cuestionario ad hoc antes y después de implementar la metodología estandarizada IDEAS en el servicio durante 2019 y 2020. Se evaluó la autopercepción personal en el procedimiento de transferencia de información. El test de Wilcoxon por pares se utilizó para la comparación antes y después. Resultados El uso de una metodología estandarizada ha mostrado un impacto en la mejora de la transmisión de la información. Se detectaron diferencias significativas antes y después de la intervención en las siguientes dimensiones: ubicación, personas implicadas, periodo de tiempo del procedimiento, estructurada ordenada y clara y tiempo suficiente para preguntas (p<0,001); mientras que no se observaron diferencias en transmisión al profesional referente, actuaciones bien definidas y realización de un resumen. Conclusiones Existen factores, como aspectos estructurales, organizativos y falta de tiempo, que dificultan la comunicación efectiva, por tanto, actúan como barreras en la transferencia de información. La implementación de una metodología con las personas implicadas, el tiempo y el espacio adecuado permite mejorar aspectos en la comunicación en el equipo multiprofesional y, por tanto, la seguridad del paciente. (AU)

Aim This study aims to describe the implementation of the standard methodology for information transfer in the labour ward and Intermediate Obstetric Care Unit and to identify the impact of this implementation on the factors that act as facilitators and barriers in the procedure. Method Quasi-experimental pretest-posttest study without a control group in an Intermediate Obstetric Care Unit and delivery room of the Maternal-Fetal Medicine Service of a tertiary hospital in Barcelona. Healthcare staff self-completed an ad hoc questionnaire before and after implementing the standardised IDEAS methodology in the service during 2019 and 2020. Personal self-perception in the information transfer procedure was assessed. The Wilcoxon pairwise test was used for comparison before and after. Results The use of a standardised methodology has shown an impact on improving the transmission of information. Significant differences were detected before and after the intervention in the following dimensions: location, people involved, time period of the procedure, structured, orderly and clear, and sufficient time for questions (p<0.001); while no differences were observed in: transmission to the referring professional, well-defined actions, and completion of a summary. Conclusions There are factors such as structural and organisational aspects and lack of time that hinder effective communication and therefore act as barriers to the transfer of information. The implementation of a methodology with the health professionals involved, the time and the appropriate space allows for the improvement of communication aspects in the multiprofessional team and, therefore, patient safety. (AU)

Impacto de la arquitectura del hospital en la experiencia de parto: un estudio fenomenológico con madres expertas en su diseño / Impact of hospital architecture on the birthing experience: a phenomenological study with mothers-to-be who are design experts

Fundamento. El lugar donde paren las madres condiciona su proceso de parto y nivel de satisfacción. El objetivo de este estudio es identificar las experiencias y percepciones acerca de los elementos de diseño del entorno del parto hasta el alta hospitalaria, que influyen en la experiencia de las madres a largo plazo. Metodología. Investigación fenomenológica de tipo método biográfico, a través del análisis temático inductivo de veinticinco testimonios de parto en el hospital, escritos por madres arquitectas, ingenieras, paisajistas o diseñadoras de interiores. Resultados. Los resultados se organizaron en cuatro temas y siete subtemas. El primer tema es la “Impresión a primera vista y largo plazo” que se subdivide en los subtemas “Itinerario despersonalizado en accesos y pasillos” y “Búsqueda instintiva de conexión con la naturaleza”. El segundo tema trata sobre el “Acompañamiento y arropamiento durante el proceso de parto” y se subdivide en “Como en un hotel: espacio para el movimiento y adaptación personalizada” y “Desamparo, frío e incertidumbre: espacios donde estar contra su voluntad”. El tercer tema son los “Daños (en espacios) colaterales”, que engloba “La integración de los aseos en el proceso de parto”, los “Quirófanos inmutables ante el parto por cesárea” y las “Salas de neonatos que no integran a las familias”. El cuarto tema incluye “Propuestas de mejora para nuevos diseños”. Conclusiones. Esta investigación permite profundizar en aspectos de diseño identificados en literatura reciente y mostrar que son necesarios más estudios que incorporen la experiencia de la mujer en el proceso del parto para promocionar políticas de diseño basadas en evidencias. (AU)

Background. The birthplace has a crucial role in shaping the childbirth experience and mothers’ satisfaction levels. This study aimed to identify the experiences and perceptions that may have an impact in the long-term on mothers’ birthing experience, considering hospital design features in the birthing environment until discharge. Methods. Inductive thematic analysis of twenty-five hospital labor testimonies employing a phenomenological research approach and utilizing a biographical method. Participants were women with a professional background in architecture, landscape architecture, engineering, or interior design. Results. The results are organized into four themes and seven subthemes. The first theme is “First sight and long term impression” which is subdivided into the subthemes “Depersonalized itinerary in entrances and corridors” and “Instinctive search for connection with nature”. The second theme deals with “Accompaniment and tucking in during the birthing process”, subdivided into “Hotel-like: space for movement and personalized adaptation” and “Helplessness, cold and uncertainty: spaces to be against one’s will”. The third theme is “Damage in collateral rooms”, which includes “The integration of toilets in the birthing process”, “Operating rooms unchangeable in the face of cesarean delivery” and “Neonatal units that do not integrate families”. Finally, the fourth theme includes “Improvement proposals for new designs”. Conclusions. This study contributes to the existing literature by deepening the understanding of the design features identified in hospitals in recent studies. Further research incorporating the experiences of women in the birthing process is needed to facilitate evidence-based design policies. (AU)

Impact of the implementation of a standardised interdisciplinary information transfer method in the delivery room and intermediate obstetric care unit.

AIM: This study aims to describe the implementation of the standard methodology for information transfer in the labour ward and Intermediate Obstetric Care Unit and to identify the impact of this implementation on the factors that act as facilitators and barriers in the procedure. METHOD: Quasi-experimental pretest-posttest study without a control group in an Intermediate Obstetric Care Unit and delivery room of the Maternal-Fetal Medicine Service of a tertiary hospital in Barcelona. Healthcare staff self-completed an ad hoc questionnaire before and after implementing the standardised IDEAS methodology in the service during 2019 and 2020. Personal self-perception in the information transfer procedure was assessed. The Wilcoxon pairwise test was used for comparison before and after. RESULTS: The use of a standardised methodology has shown an impact on improving the transmission of information. Significant differences were detected before and after the intervention in the following dimensions: location, people involved, time period of the procedure, structured, orderly and clear, and sufficient time for questions (p < 0.001); while no differences were observed in: transmission to the referring professional, well-defined actions, and completion of a summary. CONCLUSIONS: There are factors such as structural and organisational aspects and lack of time that hinder effective communication and therefore act as barriers to the transfer of information. The implementation of a methodology with the health professionals involved, the time and the appropriate space allows for the improvement of communication aspects in the multiprofessional team and, therefore, patient safety.

Impact of resuscitation training program on neonatal outcomes in a region of high socioeconomic vulnerability in Brazil: an interventional study.

OBJECTIVES: This pre/post-intervention study aimed to evaluate neonatal outcomes after the implementation of the Neonatal Resuscitation Program of the Brazilian Society of Pediatrics. METHOD: This interventional study was conducted across five secondary healthcare regions that supported 62 cities in the southwestern mesoregion of Piauí. It included 431 healthcare professionals responsible for neonatal care in the study region. The participants were trained in neonatal resuscitation through the Neonatal Resuscitation Program of the Brazilian Society of Pediatrics. Delivery room structuring, healthcare professionals' knowledge, and neonatal care outcomes were analyzed immediately before and after intervention and after 12 months between February 2018 and March 2019, and healthcare professionals were evaluated. RESULTS: Training was conducted for over 106 courses. As a participant could take multiple courses, 700 training sessions were conducted. Regarding delivery room structuring, the acquisition of materials required for resuscitation increased from 28.4 to 80.6% immediately after the intervention and to 83.3% after 12 months. Knowledge retention was significant in the post-training period, with a 95.5% approval rate, and knowledge acquisition was satisfactory after 12 months. The number of newborns transferred during the study period increased significantly. A 72.6% reduction in mortality at birth was recorded, and 479 newborns were resuscitated. CONCLUSION: Following the implementation of the Neonatal Resuscitation Program of the Brazilian Society of Pediatrics, structural improvements in delivery rooms, adequate knowledge retention regarding neonatal resuscitation, and a consequent reduction in neonatal mortality were observed.

Single Room Maternity Care Versus Traditional Maternity Care: A Cross-Sectional Study Examining Differences in Mothers' Perceptions of Readiness for Discharge and Satisfaction and Health Outcomes.

BACKGROUND: Single room maternity care (SRMC) includes all aspects of the birth process (labour, delivery, postpartum) in a single room with a consistent team of healthcare providers. Traditional maternity care (TMC) involves having mothers labouring and delivering their baby in one room and then transferring to a room on another unit, which also means a transition in providers. Although many hospitals have transitioned to SRMC, there has been limited evidence to support their development. METHODS: This study was conducted in two large hospitals (one offering SRMC, the other TMC) in Western Canada. A cross-sectional between-subjects design was used to compare differences between SRMC and TMC. New mothers were asked to complete validated questionnaires. Health information was collected from administrative and health databases. The main outcomes included readiness for hospital discharge, mothers' satisfaction, newborn length of stay, and mother length of stay. Several covariates were examined. RESULTS: In total, 506 (292 SRMC; 214 TMC) mothers participated. Readiness for discharge and maternal satisfaction were significantly higher in SRMC. Although newborn and mother length of stay were significantly reduced in SRMC compared to TMC for univariate tests, mother length of stay was not significantly different when adjusting for other variables. CONCLUSIONS: There are positive health and psychosocial outcomes for mothers and newborns in the SRMC model of care compared to TMC. Since readiness for discharge and satisfaction are associated with positive maternal-infant interactions and transitions to community, SRMC could be the better approach. Further research should examine healthcare provider outcomes and implementation costs.

Birth environments for women with complex pregnancies: A mixed-methods systematic review.

BACKGROUND: Birth environments can help support women through labour and birth. Home-like rooms which encourage active birthing are embraced in midwifery-led settings. However, this is often not reflected in obstetric settings for women with more complex pregnancies. AIM: To investigate the impact of the birth environment for women with complex pregnancies. METHODS: This was a mixed-methods systematic review, incorporating qualitative and quantitative research. A literature search was implemented across three databases (Medline, CINAHL, Embase) from the year 2000 to June 2021. Studies were eligible if they were based in an Organisation for Economic Cooperation and Development country and reported on birth environments for women with complex pregnancies. Papers were screened and quality appraised by two researchers independently. FINDINGS: 30,345 records were returned, with 15 articles meeting inclusion criteria. Studies were based in Australia, the UK, and the USA. Participants included women and health professionals. Five main themes arose: Quality of care and experience; Supportive spaces for women; Supportive spaces for midwives; Control of the space; Design issues. DISCUSSION: Women and midwives found the birth environment important in supporting, or failing to support, a positive birth experience. Obstetric environments are complex spaces requiring balance between space for women to mobilise and access birthing aids, with the need for medical teams to have easy access to the woman and equipment in emergencies. CONCLUSION: Further research is needed investigating different users' needs from the environment and how safety features can be balanced with comfort to provide high-quality care and positive experiences for women.

Shift handover qualification in obstetric unit during the pandemic period: reinventions and learning / Calificación de cambio de turno en unidad obstétrica en período de pandemia: reinvenciones y aprendizajes / Qualificação da passagem de plantão em unidade obstétrica durante período pandêmico: reinvenções e aprendizados

ABSTRACT Objective: Qualify the shift handover in an Obstetric Unit during the COVID-19 pandemic period, through Permanent Health Education. Method: Action research conducted in southern Brazil. The research was conducted from interviews with healthcare professionals and students and the data were analyzed using the Reflexive technique. Interventions took place in different work shifts, with the support of a serial album as a didactic and educational resource. Results: The data analysis made it possible to record experiences and the delineation of two thematic categories: From traditional approaches to the reinvention of learning in healthcare work; and From conformism to professional growth. Conclusion: The shift handover in the Obstetric Unit, through Permanent Health Education, enabled autonomous, interactive, and cooperative learning; awakened the desire to transcend the work routine; and highlighted the need to continuously (re)signify the healthcare work process.

RESUMEN Objetivo: Calificar el cambio de turno en la Unidad Obstétrica durante el período de pandemia de COVID-19, a través de la Educación Permanente en Salud. Método: Investigación acción realizada en la región sur de Brasil. La parte investigativa se realizó a partir de entrevistas a profesionales de la salud y estudiantes y se analizó mediante la técnica Reflexive. Ya las intervenciones se realizaron en diferentes turnos de trabajo, con el apoyo de un álbum seriado como recurso didáctico y educativo. Resultados: El análisis de datos permitió registrar experiencias y la significación de las intervenciones resultó en dos categorías temáticas: De los enfoques tradicionales a la reinvención del aprendizaje en el trabajo en salud y Del conformismo al crecimiento profesional. Conclusión: El cambio de turno en la Unidad de Obstetricia, a través de la Educación Permanente en Salud, posibilitó el aprendizaje autónomo, interactivo, colegiado; despertó el deseo de trascender la rutina laboral; y destacó la necesidad de (re)significar continuamente el proceso de trabajo en salud.

RESUMO Objetivo: Qualificar a passagem de plantão em Unidade Obstétrica durante período pandêmico da COVID-19, por meio da Educação Permanente em Saúde. Método: Pesquisa-ação realizada na região sul do Brasil. A investigação foi conduzida a partir de entrevistas com profissionais e alunos da saúde e os dados foram analisados pela técnica Reflexive. Já as intervenções ocorreram nos diferentes turnos de trabalho, com o apoio de um álbum seriado como recurso didático e educativo. Resultados: A análise dos dados possibilitou o registro de vivências e a delimitação de duas categorias temáticas: De abordagens tradicionais à reinvenção da aprendizagem no trabalho em saúde; e Do conformismo ao crescimento profissional. Conclusão: A passagem de plantão em Unidade Obstétrica, por meio da Educação Permanente em Saúde, possibilitou o aprendizado autônomo, interativo e cooperativo; despertou o desejo de transcender a rotina de trabalho; e intuiu à necessidade de (re)significar continuamente o processo de trabalho em saúde.

Impact of resuscitation training program on neonatal outcomes in a region of high socioeconomic vulnerability in Brazil: an interventional study

Abstract Objectives: This pre/post-intervention study aimed to evaluate neonatal outcomes after the implementation of the Neonatal Resuscitation Program of the Brazilian Society of Pediatrics. Method: This interventional study was conducted across five secondary healthcare regions that supported 62 cities in the southwestern mesoregion of Piauí. It included 431 healthcare professionals responsible for neonatal care in the study region. The participants were trained in neonatal resuscitation through the Neonatal Resuscitation Program of the Brazilian Society of Pediatrics. Delivery room structuring, healthcare professionals' knowledge, and neonatal care outcomes were analyzed immediately before and after intervention and after 12 months between February 2018 and March 2019, and healthcare professionals were evaluated. Results: Training was conducted for over 106 courses. As a participant could take multiple courses, 700 training sessions were conducted. Regarding delivery room structuring, the acquisition of materials required for resuscitation increased from 28.4 to 80.6% immediately after the intervention and to 83.3% after 12 months. Knowledge retention was significant in the post-training period, with a 95.5% approval rate, and knowledge acquisition was satisfactory after 12 months. The number of newborns transferred during the study period increased significantly. A 72.6% reduction in mortality at birth was recorded, and 479 newborns were resuscitated. Conclusion: Following the implementation of the Neonatal Resuscitation Program of the Brazilian Society of Pediatrics, structural improvements in delivery rooms, adequate knowledge retention regarding neonatal resuscitation, and a consequent reduction in neonatal mortality were observed.

Comprehensive promotion of perinatal collaboration for extremely preterm infants / 中华围产医学杂志

Extremely preterm infants (EPIs) are extremely immature in organ development, vulnerable to various comorbidities after birth, and may result in high mortality and disability rates. The short- and long-term prognosis of EPIs is closely related to early management. In-depth collaboration between obstetricians and pediatricians is the key to improving their quality of life. Compared to developed countries, there is much to improve in the Chinese mainland, especially in perinatal collaboration. The attitude towards EPI treatment, prenatal prophylaxis, intrauterine transport, delivery room warmth, respiratory management in the delivery room, breastfeeding, family integrated care, cord blood stem cell therapy, and other issues in the field of perinatal collaboration in China is discussed in this article, to promote the collaborative work in related fields further.

Amamentação na primeira hora de vida em município do interior do Rio de Janeiro: fatores associados / Lactancia materna en la primera hora de vida en una ciudad del interior de Río de Janeiro: factores asociados / Breastfeeding in the first hour of life in a city in the countryside of Rio de Janeiro: associated factors

Resumo Objetivo analisar a amamentação na primeira hora de vida e os fatores associados em um município do interior do Rio de Janeiro. Método estudo online transversal, realizado entre maio de 2021 e agosto de 2022, com 97 parturientes do município de Rio das Ostras. Na associação entre variáveis, adotaram-se o Teste Qui-Quadrado e regressão logística. Resultados entre as participantes, 77,3% pariram na maternidade pública e 22,7% na maternidade privada. A prevalência da amamentação na primeira hora de vida na sala de parto e no alojamento conjunto foi, respectivamente, de 21,6% e 58,3%, com diferenças significativas entre as maternidades. Puérperas da maternidade pública tiveram mais chances de não amamentar na primeira hora de vida. Ter ensino básico aumentou as chances de o bebê não ser amamentado na sala de parto e não realizar contato pele a pele precoce, além de não ser amamentado no alojamento conjunto. Conclusão e implicações para a prática a amamentação na primeira hora de vida não atingiu níveis preconizados, e distintos fatores associados à sua ocorrência foram identificados, como nível de instrução, local do parto e contato pele a pele. Recomenda-se que maternidades implementem as práticas humanizadas no cuidado ao recém-nascido, para elevar as taxas da amamentação na primeira hora de vida.

Resumen Objetivo analizar la lactancia materna en la primera hora de vida y los factores asociados en una ciudad del interior de Río de Janeiro. Método estudio transversal en línea, realizado entre mayo de 2021 y agosto de 2022, con 97 parturientas en el municipio de Rio das Ostras. En la asociación entre variables se utilizó la prueba de chi-cuadrado y regresión logística. Resultados entre las participantes, 77,3% dieron a luz en la maternidad pública y 22,7% en la maternidad privada. La prevalencia de lactancia materna en la primera hora de vida en paritorio y en alojamiento conjunto fue, respectivamente, del 21,6% y del 58,3%, con diferencias significativas entre maternidades. Las puérperas de la maternidad pública fueron más propensas a no amamantar en la primera hora de vida. Tener educación básica aumentó las posibilidades de que el bebé no fuera amamantado en la sala de partos y no tuviera contacto piel a piel temprano, además de no ser amamantado en el alojamiento conjunto. Conclusión e implicaciones para la práctica la lactancia materna en la primera hora de vida no alcanzó los niveles recomendados y se identificaron diferentes factores asociados a su ocurrencia, como el nivel de instrucción, el lugar del parto y el contacto piel con piel. Se recomienda que las maternidades implementen prácticas humanizadas en la atención al recién nacido para incrementar las tasas de lactancia materna en la primera hora de vida.

Abstract Objective to analyze breastfeeding in the first hour of life and associated factors in a city in the countryside of Rio de Janeiro. Method a cross-sectional online study, carried out between May 2021 and August 2022, with 97 parturient women in the municipality of Rio das Ostras. In the association between variables, the chi-square test and logistic regression were used. Results among the participants, 77.3% gave birth in the public maternity hospital and 22.7% in the private maternity hospital. The prevalence of breastfeeding in the first hour of life in the delivery room and in rooming-in was, respectively, 21.6% and 58.3%, with significant differences between maternity hospitals. Postpartum women from the public maternity hospital were more likely to not breastfeed in the first hour of life. Having basic education increased the chances of the baby not being breastfed in the delivery room and not having early skin-to-skin contact and not breastfeeding breastfed in rooming-in. Conclusion and implications for practice breastfeeding in the first hour of life did not reach recommended levels and different factors associated with its occurrence were identified, such as education level, place of childbirth and skin-to-skin contact. It is recommended that maternity hospitals implement humanized practices in newborn care to increase breastfeeding rates in the first hour of life.

Amamentação na primeira hora de vida na maternidade: fatores intervenientes / Factors intervening in breastfeeding in the first hour of life on the maternity ward / Factores interventores en la lactancia materna en la primera hora de vida en la maternidad

Objetivo: descrever os fatores intervenientes na amamentação na primeira hora de vida na maternidade na perspectiva de puérperas e profissionais de enfermagem. Método: estudo qualitativo, desenvolvido no segundo semestre de 2019, em um hospital do interior do Rio de Janeiro, mediante entrevistas semiestruturadas. Utilizaram-se o software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRAMUTEQ®) e a Análise Temática. Protocolo de pesquisa aprovado pelo Comitê de Ética em Pesquisa. Resultados: percebeu-se que nem todos os recém-nascidos são amamentados na primeira hora por fatores ligados à mãe, condições clínicas do bebê, tipo de parto, profissionais ou instituição. O teste rápido anti-HIV se mostrou um fator limitador, pois seu resultado é liberado somente após o parto. Ademais, as orientações pela equipe de enfermagem favorecem essa prática, enquanto a falta de rotina a prejudica. Conclusão: fatores multidimensionais interferem na amamentação na primeira hora de vida na maternidade.

Objective: to describe the factors intervening in breastfeeding in the first hour of life in the maternity ward from the perspective of mothers and nursing personnel. Method: this qualitative study was conducted semi-structured interviews, in the second half of 2019, in a hospital in the interior of Rio de Janeiro State. The Interface de R pour les Analyzes Multidimensionnelles de Textes et de Questionnaires (IRAMUTEQ®) and Thematic Analysis were used. The research protocol approved by the research ethics committee. Results: it was found that not all newborns are breastfed in the first hour due to factors relating to the mother, the baby's clinical condition, delivery type, health personnel, and institution. The rapid anti-HIV test proved to be a limiting factor, as the result is released only after delivery. Furthermore, the guidelines provided by the nursing team favor this practice, while the lack of that routine harms it. Conclusion: multidimensional factors interfere with breastfeeding in the first hour of life on the maternity ward.

Objetivo: describir los factores que intervienen en la lactancia materna en la primera hora de vida en la sala de maternidad en la perspectiva de las madres y profesionales de enfermería. Método: estudio cualitativo, desarrollado durante el segundo semestre de 2019, en un hospital del interior de Río de Janeiro, a través de entrevistas semiestructuradas. Se utilizaron los softwares Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRAMUTEQ®) y el Análisis Temático. El Comité de Ética en Investigación aprobó el protocolo de investigación. Resultados: se percibió que no todos los neonatos son amamantados en la primera hora debido a factores relacionados con la madre, condiciones clínicas del bebé, tipo de parto, profesionales o institución. La prueba rápida anti-VIH resultó ser un factor limitante, ya que su resultado se da a conocer sólo después del parto. Además, las orientaciones proporcionadas por el equipo de enfermería favorecen esa práctica, mientras que la falta de rutina la perjudica. Conclusión: factores multidimensionales interfieren en la lactancia materna en la primera hora de vida en la sala de maternidad.

Estratégia educativa para assistência ao recém-nascido na sala de parto na pandemia de COVID-19 / Estrategia educativa para la atención del recién nacido en la sala de parto en la pandemia del COVID-19 / Educational strategy for newborn assistance in the birth room in the COVID-19 pandemic

Objetivo: desenvolver e validar folder educativo com recomendações sobre a assistência ao recém-nascido na sala de parto no contexto da covid-19. Métodos: estudo metodológico com construção de folder educativo e validação de conteúdo por 22 juízes experts. Os critérios de inclusão foram: profissional da saúde com experiência na assistência, pesquisa ou docência, com foco na saúde obstétrica/neonatal. Utilizou-se as questões adaptadas do Índice de Validação de Conteúdo Educacional, sendo considerado válido o item com Índice de Validação de Conteúdo e teste binomial maior que 0,8. O estudo foi aprovado pelo Comitê de Ética em Pesquisa, sob parecer n° 4.688.121. Resultados: o folder aborda recomendações sobre a assistência ao recém-nascido na sala de parto durante a pandemia de covid-19. Foi verificada concordância superior a 80% em todos os itens avaliados pelos juízes. Conclusão: o folder mostrou-se válido quanto ao seu conteúdo e constitui recurso tecnológico relevante para a prática assistencial.(AU)

Objective: to develop and validate the educational folder on newborn care in the context of covid-19. Methods: methodological study with the construction of an educational folder and content validation by 2 expert judges2. Inclusion criteria were: health professional with experience in care, research or teaching, with a focus on obstetric/neonatal health. It was used as questions adapted from the Educational Content Validation Index, being considered valid the item with Content Validation Index and binomial test greater than 0.8. The study was approved by the Research Ethics Committee, under opinion No. 4,688,121. Results: the delivery addressed on the assistance to the newborn in the room during the covid-19 pandemic. It was an agreement greater than 80% in all items evaluated by the judges. Conclusion: the folder proved to be valid in terms of its content and constitutes a relevant technological resource for care practice.(AU)

Objetivo: elaborar y validar una carpeta educativa con recomendaciones sobre el cuidado del recién nacido en sala de partos en el contexto del covid-19. Métodos: estudio metodológico con construcción de carpeta educativa y validación de contenido por 22 jueces expertos. Los criterios de inclusión fueron: profesional de la salud con experiencia asistencial, investigadora o docente, con enfoque en salud obstétrica/neonatal. Se utilizaron preguntas adaptadas del Índice de Validación de Contenido Educativo, y se consideró válido el ítem con Índice de Validación de Contenido y prueba binomial superior a 0,8. El estudio fue aprobado por el Comité de Ética en Investigación, bajo el dictamen no 4.688.121. Resultados: la carpeta aborda recomendaciones sobre el cuidado del recién nacido en la sala de partos durante la pandemia de covid-19. Se verificó una concordancia superior al 80% en todos los ítems evaluados por los jueces. Conclusión: la carpeta demostró ser válida en cuanto a su contenido y constituye un recurso tecnológico relevante para la práctica del cuidado.(AU)

Duration of skin-to-skin care and rectal temperatures in late preterm and term infants.

BACKGROUND: Hypothermia during the newborn period is widely regarded as a major contributory cause of significant morbidity and mortality of newborn infants. Thermoprotective behaviours such as skin-to-skin care (SSC) or the use of appropriate devices have been recommended as simple tools for the avoidance of neonatal hypothermia. We examined the relation between the duration of skin-to-skin care and infant temperature change after birth in suboptimal delivery room temperatures. METHODS: We reviewed the medical charts of all vaginally born infants of gestational age ≥ 35 weeks born January-July 2018 and admitted to the well-baby nursery. After SSC was discontinued, the infant's rectal temperature was measured to determine the frequency and severity of hypothermia. RESULTS: The charts of 688 vaginally born infants were examined. Our mean delivery room temperature was 21.7 (SD 2.2) °C, well below the WHO recommendation of 25 °C. After SSC 347 (50.4%) infants were normothermic (temperature 36.5-37.5 °C), 262 (38.0%) were mildly hypothermic (36.0-36.4 °C), and 79 (11.4%) were moderately hypothermic (32.0-35.9 °C). The mean skin-to-skin time in infants was 63.9 (SD 20.9) minutes. SSC duration was associated with increase in rectal temperature for patients of gestational ages ≥ 38 weeks and with decrease in rectal temperature in patients of gestational age < 38 weeks. CONCLUSION: SSC is effective, even at suboptimal delivery room temperatures, for promoting normothermia in infants of ≥ 38 weeks' gestation but may not provide adequate warmth for infants of < 38 weeks.

Fetal Left Ventricular Apical Aneurysm Progressing to Dilated Cardiomyopathy Due to Glycogen Storage Disease.

Fetal dilated cardiomyopathy is a rare anomaly characterized by ventricular dilation and dysfunction. Its causes are diverse, and its outcomes are generally dismal. We describe a rare case of prenatally diagnosed left ventricular apical aneurysm that progressed rapidly to dilated cardiomyopathy. At age 2 months, the infant underwent heart transplantation. Pathologic examination of the explanted heart revealed that the cause of the dilated cardiomyopathy was glycogen storage disease. This case highlights the crucial roles of timely diagnosis, frequent close monitoring, and multidisciplinary care in achieving a successful postnatal outcome.

The Effects of Musculoskeletal Disorders on Professional Quality of Life Among Midwives Working in Delivery Rooms.

Background: This study was conducted to determine the effects of musculoskeletal disorders on professional quality of life among midwives working in delivery rooms. Aim: The aim of the study was to determine the effect of musculoskeletal disorders of midwives working in delivery rooms on the quality of professional life. Methods: This descriptive study was conducted with 88 midwives who worked in delivery rooms and delivered babies. The data were collected using the Nordic Musculoskeletal Questionnaire (NMQ) and the Professional Quality of Life Scale (ProQOL R-IV). Statistical Analysis Used: The data were analysed with IBM SPSS V23 using MANOVA and path analysis. Results: Of the midwives, 80.7% reported that they had pain in the waist in the last year. According to the result of path analysis for NMQ and ProQOL R-IV, only the path coefficient between the 12-month disability and burnout was found to be statistically significant (p = 0.012). The multivariate analysis showed that single midwives had higher job satisfaction than married ones (p = 0.030) and those who chose their profession willingly had higher job satisfaction than others (p = 0.043). Conclusion: It was observed that most of the midwives suffered from low back pain. Additionally, there may be a relationship between musculoskeletal problems experienced by midwives and their professional burnout levels. Relevant strategies to reduce occupational risks, especially musculoskeletal disorders, and to increase the professional quality of life of midwives should be implemented urgently.

Preparation for neonatal resuscitation in delivery room / 中华围产医学杂志

Correct neonatal resuscitation is the primary way to reduce perinatal mortality and neurological sequelae, and adequate preparation is essential. This article introduces the details for preparing neonatal resuscitation (including antenatal consultation) and ways to optimize the practice, aiming to improve the success rate of neonatal resuscitation.

Relations of power and oppression within the delivery room: nursing narratives / Relaciones de poder y opresión dentro de la sala de parto: narrativas de enfermería / Relaciones de poder y opresión dentro de la sala de parto: narrativas de enfermería

ABSTRACT Objective: To analyze, from the perspective of decolonial feminism, the power and oppression relations experienced by nurses in the delivery room in a hospital in Mexico. Method: Qualitative study in which 15 nurses selected by theoretical sampling were interviewed. The interviews were fully transcribed and subsequently analyzed using content analysis. Results: The emerging central category was "Inter- and intragender power/oppression relations" and psychological and symbolic violence were the most frequent types. Gender was confirmed as the most important structural determinant of oppression, cutting across bodies and professional identities. The conditions contributing to intragender conflict are age, expertise, and specialization. Three coping resources were documented: defenselessness, complicity and resistance. Conclusion: It is necessary to denaturalize the forms of power/oppression sustained by gender inequalities, but also to discuss other conditions that determine power/oppression relations between women and colleagues. Eradicating intra-gender and intergender violence is necessary to access safe working environments that promote creativity for the exercise of care.

RESUMO Objetivo: Analisar as relações de poder e opressão vivenciadas por enfermeiras na sala de parto de um hospital no México sob a perspectiva do feminismo decolonial. Método: Estudo qualitativo no qual foram entrevistadas 15 enfermeiras selecionadas por amostragem teórica. As entrevistas transcritas na íntegra foram posteriormente submetidas à análise de conteúdo. Resultados: A categoria central emergente foi "Relações inter e intragênero de poder/opressão" e as formas psicológica e simbólica de violência foram as mais frequentes. O gênero foi o mais importante determinante estrutural da opressão, atravessando corpos e identidades profissionais. As condições que contribuem para o conflito intragênero são idade, perícia habilidade e especialização. Três recursos de enfrentamento foram documentados: vulnerabilidade, cumplicidade e resistência. Conclusão: É necessário desnaturalizar as formas de poder/opressão sustentadas pelas desigualdades de gênero e discutir outras condições que determinam as relações de poder/opressão entre mulheres e colegas. Erradicar a violência intragênero e intergênero é necessário para acessar ambientes de trabalho seguros que promovam a criatividade para o exercício do cuidado.

RESUMEN Objetivo: Analizar desde la perspectiva del feminismo descolonial, las relaciones de poder y opresión que viven enfermeras dentro de la sala de parto en un hospital de México. Método: Estudio cualitativo en el que se entrevistó a 15 enfermeras seleccionadas por muestreo teórico. Las entrevistas transcritas en totalidad fueron sometidas posteriormente a análisis de contenido. Resultados: La categoría central emergente fue "Relaciones de poder/opresión inter e intragénericas" y las formas más frecuentes de violencia fueron psicológicas y simbólicas. El género se confirmó como el condicionante estructural más importante de la opresión, atravesando los cuerpos y las identidades profesionales. Las condiciones que contribuyen al conflicto intragénero son la edad, la expertis y la especialización. Se documentaron tres recursos para el afrontamiento: indefensión, complicidad y resistencia. Conclusión: Es necesario desnaturalizar las formas de poder/opresión sustentadas en las desigualdades de género, pero también discutir otras condiciones que determinan relaciones de poder/opresión entre mujeres y colegas. Erradicar las violencias intragenéricas e integénericas es necesario para acceder a entornos laborales seguros y que potencien la creatividad para ejercer el cuidado.

Adherence to humanized care practices for newborns with good vitality in the delivery room / Adherencia a las prácticas de atención humanizada para recién nacidos con buena vitalidad en la sala de partos / Adesão às práticas assistenciais humanizadas ao recém-nascido com boa vitalidade na sala de parto

ABSTRACT Objective: To know the intervening factors in the adherence of health professionals to humanized care practices for newborns with good vitality in the delivery room. Method: Qualitative research, through an online form with 36 health professionals working in delivery rooms in Rio de Janeiro. Data processed in the Interface de R pour Analyses Multidimensionnelles de Textes Et de Questionnaires and analyzed according to Thematic Content Analysis. Results: Skin-to-skin contact was identified as a factor that is directly related to timely clamping of the umbilical cord and breastfeeding in the first hour of life. Other intervening factors were: acceptance, training and professional category; type of delivery; qualification and training of teams. Conclusions: Professional improvement combined with encouragement from the leadership, partnership between peers, good working conditions, human resources and infrastructure and guidance to families provide adherence to humanized care practices for the newborn in the delivery room.

RESUMEN Objetivo: Conocer factores involucrados en la adhesión de los profesionales de la salud a las prácticas de atención humanizada al recién nacido con buena vitalidad en la sala de partos. Método: Investigación cualitativa, utilizando un formulario en línea con 36 profesionales de la salud que trabajan en salas de parto en el estado de Río de Janeiro. Datos procesados mediante la Interface de R pour Analyses Multidimensionnelles de Textes Et de Questionnaires y analizados mediante Thematic Content Analysis. Resultados: El contacto piel con piel se identificó como un factor que está directamente relacionado con la realización del pinzamiento oportuno del cordón umbilical y la lactancia materna en la primera hora de vida. Otros factores fueron: aceptación, formación y categoría profesional; tipo de entrega; calificación y entrenamiento de los equipos. Conclusiones: La superación profesional combinada con el estímulo del liderazgo, la colaboración entre pares, las buenas condiciones de trabajo, los recursos humanos y la infraestructura y la orientación a las familias brindan adherencia a las prácticas de cuidado humanizado del recién nacido en la sala de partos.

RESUMO Objetivo: Conhecer os fatores intervenientes à adesão dos profissionais de saúde às práticas assistenciais humanizadas ao recém-nascido com boa vitalidade na sala de parto. Método: Pesquisa qualitativa, mediante formulário online com 36 profissionais de saúde atuantes em salas de parto no estado do Rio de Janeiro. Dados processados no Interface de R pour Analyses Multidimensionnelles de Textes Et de Questionnaires e analisados segundo Análise de Conteúdo Temática. Resultados: Identificou-se o contato pele a pele como fator que se relaciona diretamente à realização do clampeamento oportuno do cordão umbilical e amamentação na primeira hora de vida. Outros fatores intervenientes foram: aceitação, formação e categoria profissional; tipo de parto; capacitação e treinamento das equipes. Conclusões: Aprimoramento profissional aliado ao estímulo da chefia, parceria entre pares, boas condições de trabalho, de recursos humanos e de infraestrutura e orientações às famílias propiciam a adesão às práticas assistenciais humanizadas ao recém-nascido na sala de parto.