Assessment of the quality of natural childbirth care in hospital setting through the Bologna index
Abstract
Objective: To assess the quality of care during natural childbirth in hospital setting through the Bologna Index.
Method: This is an observational and cross-sectional study, with a quantitative design, performed in a reference service in obstetric care, located in the Northeast region/Brazil. A form based on the quality indicators of the Bologna Index and guidelines for natural childbirth and puerperal care was used. Data were analyzed through descriptive and inferential statistics. When analyzing the Bologna Index, 1 point was assigned to each variable met; and, after assessing each item, care was classified based on the following sum: “0” for lower quality, “1 to 4” for intermediate quality and “5” for higher quality of care.
Results: It was found an average of 3.44 in the Bologna Index, corresponding to intermediate quality care. Among the five variables that make up the Bologna Index, the highest percentages were related to the use of partograph (85.4%), presence of a caregiver at the time of childbirth (94.5%) and skin-to-skin contact between mother and child in the first hour of life (98.1%). Nevertheless, there was a reduced percentage regarding the use of non-supine positions (9.1%) and absence of stimuli in the first clinical period of childbirth (56.3%).
Conclusion: there has been progress in the quality of childbirth care in hospital setting, but it is necessary to provide information for the empowerment of women, greater adherence of professionals to good obstetric practices and insertion of nurses in the usual-risk obstetric care.
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References
Genovesi FF, Canario MASS, Godoy CB, Maciel SM, Cardelli AAM, Ferrari RAP.Maternal and child health care: adequacy index in public health services. Rev Bras Enferm [Internet]. 2020 [acesso 2021 Mar 25]; 73(Suppl 4). Disponível em: https://doi.org/10.1590/0034-7167-2017-0757
Bourguignon AM, Grisotti M. A humanização do parto e nascimento no Brasil nas trajetórias de suas pesquisadoras. Hist Cienc Saude Manguinhos [Internet]. 2020 [acesso 2021 Mar 25]; 27(2):485-502. Disponível em: https://doi.org/10.1590/S0104-59702020000200010
Leal MC, Bittencourt SA, Esteves-Pereira AP, Ayres BVS, Silva LBRAA, Thomaz EBAF, et al. Progress in childbirth care in Brazil: preliminary results of two evaluation studies. Cad Saúde Pública [Internet]. 2019 [acesso 2021 Mar 26];35(7):e00223018. Disponível em: https://doi.org/10.1590/0102-311X00223018
Carvalho SS, Silva CS. Revisão integrativa: promoção das boas práticas na atenção ao parto normal. Rev Aten Saúde [Internet]. 2020 [acesso 2021 Mar 27];18(63):110-9. Disponível em: https://dx.doi.org//10.13037/ras.vol18n63.6290
Vieira BC, Backes MTS, Costa LD, Fernandes VMB, Dias HHZR, Backes DS.Applying best practices to pregnant women in the obstetric center. Rev Bras Enferm[Internet]. 2019 [acesso 2021 Mar 27];72:191-6. Disponível em: https://doi.org/10.1590/0034-7167-2018-0422
Ministério da Saúde (BR). Portaria nº 1.459, de 24 de junho de 2011. Institui a Rede Cegonha. Diário Oficial da União, Brasília (DF), 2011 [acesso 2021 Mar 29]. Disponível em: http://bvsms.saude.gov.br/bvs/saudelegis/gm/2011/prt1459_24_06_2011.html
Leal MS, Moreira RCR, Barros KCC, Servo MLS, Bispo TCF. Humanization practices in the parturitive course from the perspective of puerperae and nurse-midwives. Rev Bras Enferm [Internet]. 2021 [acesso 2021 Mai 9];74(Suppl 4):e20190743. Disponível em: https://doi.org/10.1590/0034-7167-2019-0743
Moura NAS, Holanda VR, Albuquerque GPM, Castro JFL, Silva HRL, Rocha EPG.Analysis of practices in childbirth and postpartum hospital care. Rev Rene [Internet]. 2020 [acesso 2021 Mar 30];21:e43671. Disponívelem: https://doi.org/10.15253/2175-6783.20202143671
Carvalho IS, Brito RS. Using the Bologna Score to assess normal delivery healthcare. Rev Esc Enferm USP [Internet]. 2016 [acesso 2021 Mar 30];50(5):741-8. Disponível em: http://dx.doi.org/10.1590/S0080-623420160000600005
Organização Mundial de Saúde. Assistência ao parto normal: um guia prático [Internet]. Saúde materna e neonatal. Unidade de maternidade segura. Saúde reprodutiva e da família. Genebra: OMS, 1996 [cited 2021 Abr 2]. Disponível em: https://www.yumpu.com/pt/document/view/42116270/maternidade-segura-aben
Ministério da Saúde (BR). Diretrizes nacionais de assistência ao parto normal: versão resumida. Brasília: Ministério da Saúde; 2017 [acesso 2021 Abr 2]. Disponível em:http://bvsms.saude.gov.br/bvs/publicacoes/diretrizes_nacionais_assistencia_parto_normal.pdf
World Health Organization. WHO recommendations: intrapartum care for a positive childbirth experience. Geneva: World Health Organization; 2018 [acesso 2021 Abr 9]. Disponívelem: https://www.who.int/publications/i/item/9789241550215
Vilela MEA, Leal MC, Thomaz EBAF, Gomes MASM, Bittencourt SDA, Gama SGN, et al. Assessment of delivery and childbirth care in the maternity units of RedeCegonha: the methodological paths. CiêncSaúde Colet [Internet]. 2021 [acesso 2021 Abr 16];26(3):789-800. Disponívelem: https://doi.org/10.1590/1413-81232021263.10642020
Lopes GDC, Gonçalves AC, Gouveia HG, Armellini CJ. Attention to childbirth and delivery in a university hospital: comparison of practices developed after Network Stork. Rev Lat Am Enfermagem[Internet]. 2019 [acesso 2021 Abr 16];27:e3139.Disponívelem: https://doi.org/10.1590/1518-8345.2643-3139
Gama SGN, Viellas EF, Medina ET, Angulo-Tuesta A, Silva CKRT, Silva SD. Delivery care by obstetric nurses in maternity hospitals linked to the RedeCegonha, Brazil - 2017. Ciênc Saúde Colet [Internet]. 2021 [acesso 2021 Abr 17];26(3):919-29. Disponível em: https://doi.org/10.1590/1413-81232021263.28482020
Ritter SK, Gonçalves AC, Gouveia HG. Care practices in normal-risk births assisted by obstetric nurses. Acta Paul Enferm [Internet]. 2020 [acesso 2021 Abr 17]; 33:eAPE20180284. Disponível em: https://doi.org/10.37689/acta-ape/2020AO0284
Nucci M, Nakano AR, Teixeira LA. Synthetic oxytocin and hastening labor: reflections on the synthesis and early use of oxytocin in Brazilian obstetrics. Hist Cienc Saude Manguinhos [Internet]. 2018 [acesso 2021 Abr 17];25(4):979-98. Disponível em: https://doi.org/10.1590/S0104-59702018000500006
Johansson C, Finnbogadóttir H. First-time mothers’ satisfaction with their birth experience–a cross-sectional study. Midwifery [Internet]. 2019 [acesso 2021 Abr 22];79:102540. Disponível em: https://doi.org/10.1016/j.midw.2019.102540
Pereira LR, Rodrigues GMM, Ferreira ES, Barros INM, Carneiro MS, Siqueira LS. Normal childbirth and interventions in a public maternity. Rev BaianaEnferm [Internet]. 2019 [acesso 2021 Abr 22];33:e-32631. Disponível em: http://dx.doi.org/10.18471/rbe.v33.32631
Nascimento KIM, Lima VS, Novaes CDP, Ponte AR, Aragão CRB, Trindade GBM, et al. Manobra de Kristeller: uma violência obstétrica. Braz J Health Rev [Internet]. 2021 [acesso 2021 Abr 29];4(2):7362-80. Disponível em: https://doi.org/10.34119/bjhrv4n2-278
Silva LF, Sanches METL, Santos AAP, Oliveira JCS, Acioli DMN, Santos JAM. Adesão às boas práticas obstétricas: construção da assistência qualificada em maternidades-escolas. Rev. baiana enferm [Internet]. 2021 [acesso 2021 Abr 29];35:e37891. Disponível em: http://dx.doi.org/10.18471/rbe.v35.37891
Lucena TS, Morais RJL, Santos AAP. Analysis of partogram completion as good obstetric practice in the monitoring of labor. Rev Pesqui (Univ Fed Estado Rio J, Online). [Internet]. 2019 [acesso 2021 Abr 29];11(1):222-7. Disponível em: https://doi.org/10.9789/2175-5361.2019.v11i1.222-227
Lima SBG, Schirmer J, Dotto LMG, Santos CL. Obstetric practices adopted by a public maternity in Rio Branco-AC. Cogitare Enferm [Internet]. 2018 [acesso 2021 Abr 29]; (23)4:e53258. Disponível em: http://dx.doi.org/10.5380/ce.v23i4.53258
Medeiros AB,Freire ILS, Santos FR, Silva BCO, Batista GFM, Menezes MM. Partograma: instrumento de segurança no cuidado multidisciplinar. Rev Cuid (Bucaramanga. 2010). [Internet]. 2020 [acesso 2021 Mai 8];11(3):e1046. Disponível em: https://doi.org/10.15649/cuidarte.1046
Tomasi YT, Saraiva SS, Boing AC, Delziovo CR, Wagner KJP, Boing AF. From prenatal care to childbirth: a cross-sectional study on the influence of a companion on good obstetric practices in the Brazilian National Health System in Santa Catarina State, 2019. EpidemiolServSaúde[Internet]. 2021 [acesso 2021 Mai 8];30(1):e2020383. Disponível em: http://dx.doi.org/10.1590/s1679-49742021000100014
Ministério da Saúde (BR). Lei nº 11.108, de 7 de abril de 2005. Garante as parturientes o direito à presença de acompanhante durante o trabalho de parto, parto e pós-parto imediato, no âmbito do SUS. Diário Oficial da União, Brasília (DF), 2005 [acesso 2021 Abr 8]. Disponível em: http://www.planalto.gov.br/ccivil_03/_ato2004-2006/2005/lei/l11108.htm.
Souza HLR, Fernandes FECV, Pereira RCLF, Melo RA. Compreensão da enfermagem sobre o contato pele a pele entre mãe/bebê na sala de parto. Rev Enferm UFSM [Internet]. 2020 [acesso 2021 Mai 8];10(e93):1-19. Disponível em: https://doi.org/10.5902/2179769242729
Bomfim ANA, Couto TM, Lima KTRS, Almeida LTS, Santos GO, Santana AT. Women’s perceptions about nursing care during normal delivery. Rev Baiana Enferm [Internet]. 2021 [acesso 2021 Mai 8];35:e39087. Disponível em: http://dx.doi.org/10.18471/rbe.v35.39087
Santos Filho SB, Souza KV. RedeCegonha network and the methodological challenges of implementing networks in the SUS. Ciênc Saúde Colet [Internet]. 2021 [acesso 2021 Mai9];26(3):775-80. Disponível em: https://doi.org/10.1590/1413-81232021263.21462020
Gomes CBA, Dias RS, Silva WGB, Pacheco MAB, Sousa FGM, Loyola CMD. Prenatal nursing consultation: Narratives of pregnant women and nurses. Texto Contexto Enferm [Internet].2019 [acesso 2021 mai 9];28:e20170544. Disponível em: http://dx.doi.org/10.1590/1980-265X-TCE-2017-0544
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