Evaluation of labor and childbirth care by nurse-midwives in Brazilian private hospitals: results of a quality improvement project

Detalhes bibliográficos
Autor(a) principal: Souza, Fabrine C.
Data de Publicação: 2023
Outros Autores: Domingues, Rosa Maria Soares Madeira, Torres, Jacqueline Alves, Gomes, Maysa Luduvice, Leal, Maria do Carmo
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/58602
Resumo: This work was supported, in part, by the Bill & Melinda Gates Foundation [OPP1142172] and by DECIT/MoH Brazil/CNPq [401715/2015-9]. Under the grant conditions of the Foundation, a Creative Commons Attribution 4.0 Generic License has already been assigned to the Author Accepted Manuscript version that might arise from this submission. The funders had no influence in the identification, design, conduct, and reporting of the analysis.
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spelling Souza, Fabrine C.Domingues, Rosa Maria Soares MadeiraTorres, Jacqueline AlvesGomes, Maysa LuduviceLeal, Maria do Carmo2023-05-24T02:17:54Z2023-05-24T02:17:54Z2023SOUZA, Fabrine C. et al. Evaluation of labor and childbirth care by nurse-midwives in Brazilian private hospitals: results of a quality improvement project. Reproductive Health, v. 20, Suppl. 2, p. 1-12, Jan. 2023.1742-4755https://www.arca.fiocruz.br/handle/icict/5860210.1186/s12978-022-01537-01742-4755This work was supported, in part, by the Bill & Melinda Gates Foundation [OPP1142172] and by DECIT/MoH Brazil/CNPq [401715/2015-9]. Under the grant conditions of the Foundation, a Creative Commons Attribution 4.0 Generic License has already been assigned to the Author Accepted Manuscript version that might arise from this submission. The funders had no influence in the identification, design, conduct, and reporting of the analysis.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Programa de Pós-Graduação em Epidemiologia em Saúde Pública. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brazil.Institute for Healthcare Improvement - IHI. Boston, MA, USA.Universidade do Estado do Rio de Janeiro. Faculdade de Enfermagem. Departamento de Enfermagem Materno-Infantil. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Rio de Janeiro, RJ, Brazil.Background: In 2015, a quality improvement project-the "Adequate Childbirth Project" (Projeto Parto Adequado, or PPA)-was implemented in Brazilian private hospitals with the goal of reducing unnecessary cesarean sections. One of the strategies adopted by the PPA was the implementation of labor and childbirth care by nurse-midwives. The objective of this study is to evaluate the results of the PPA in the implementation and adequacy of labor and childbirth care by nurse-midwives in Brazilian private hospitals. Methods: Cross-sectional, hospital-based study, carried out in 2017, in 12 hospitals participating in the PPA. We assessed the proportion of women assisted by nurse-midwives during labor and childbirth care and the adequacy of 13 care practices following parameters of the World Health Organization. Women assisted in the PPA model of care and in the standard of care model were compared using the chi-square statistical test. Results: 4798 women were interviewed. Women in the PPA model of care had a higher proportion of labor (53% × 24.2%, p value < 0.001) and vaginal birth (32.7% × 11.3%, p value < 0.001), but no significant differences were observed in the proportion of women assisted by nurse-midwives during labor (54.8% × 50.1%, p value = 0.191) and vaginal birth (2.2% × 0.7%, p value = 0.142). The implementation of recommended practices was adequate, except the use of epidural analgesia for pain relief, which was intermediate. There was a greater use of recommended practices including "oral fluid and food", "maternal mobility and position", "monitoring of labor", "use of non-pharmacological methods for pain relief" and "epidural analgesia for pain relief" in women assisted by nurse-midwives in relation to those assisted only by doctors. Many non-recommended practices were frequently used during labor by nurse-midwives and doctors. Conclusions: There was an increase in the proportion of women with labor and vaginal birth in the PPA model of care and an appropriate use of recommended practices in women assisted by nurse-midwives. However, there was no difference in the proportion of women assisted by nurse-midwives in the two models of care. The expansion of nursing participation and the reduction of overused practices remain challenges.engBioMed CentralEvaluation of labor and childbirth care by nurse-midwives in Brazilian private hospitals: results of a quality improvement projectinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleHealth evaluationHospitalsMidwiferyNatural childbirthPrivateQuality improvementinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-82991https://www.arca.fiocruz.br/bitstream/icict/58602/1/license.txt5a560609d32a3863062d77ff32785d58MD51ORIGINALve_Fabrine_Souza_etal_ENSP_INI_2023.pdfve_Fabrine_Souza_etal_ENSP_INI_2023.pdfapplication/pdf1109013https://www.arca.fiocruz.br/bitstream/icict/58602/2/ve_Fabrine_Souza_etal_ENSP_INI_2023.pdfed6151942ad3055a01faa063f067e21dMD52icict/586022023-05-23 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dc.title.en_US.fl_str_mv Evaluation of labor and childbirth care by nurse-midwives in Brazilian private hospitals: results of a quality improvement project
title Evaluation of labor and childbirth care by nurse-midwives in Brazilian private hospitals: results of a quality improvement project
spellingShingle Evaluation of labor and childbirth care by nurse-midwives in Brazilian private hospitals: results of a quality improvement project
Souza, Fabrine C.
Health evaluation
Hospitals
Midwifery
Natural childbirth
Private
Quality improvement
title_short Evaluation of labor and childbirth care by nurse-midwives in Brazilian private hospitals: results of a quality improvement project
title_full Evaluation of labor and childbirth care by nurse-midwives in Brazilian private hospitals: results of a quality improvement project
title_fullStr Evaluation of labor and childbirth care by nurse-midwives in Brazilian private hospitals: results of a quality improvement project
title_full_unstemmed Evaluation of labor and childbirth care by nurse-midwives in Brazilian private hospitals: results of a quality improvement project
title_sort Evaluation of labor and childbirth care by nurse-midwives in Brazilian private hospitals: results of a quality improvement project
author Souza, Fabrine C.
author_facet Souza, Fabrine C.
Domingues, Rosa Maria Soares Madeira
Torres, Jacqueline Alves
Gomes, Maysa Luduvice
Leal, Maria do Carmo
author_role author
author2 Domingues, Rosa Maria Soares Madeira
Torres, Jacqueline Alves
Gomes, Maysa Luduvice
Leal, Maria do Carmo
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Souza, Fabrine C.
Domingues, Rosa Maria Soares Madeira
Torres, Jacqueline Alves
Gomes, Maysa Luduvice
Leal, Maria do Carmo
dc.subject.en.en_US.fl_str_mv Health evaluation
Hospitals
Midwifery
Natural childbirth
Private
Quality improvement
topic Health evaluation
Hospitals
Midwifery
Natural childbirth
Private
Quality improvement
description This work was supported, in part, by the Bill & Melinda Gates Foundation [OPP1142172] and by DECIT/MoH Brazil/CNPq [401715/2015-9]. Under the grant conditions of the Foundation, a Creative Commons Attribution 4.0 Generic License has already been assigned to the Author Accepted Manuscript version that might arise from this submission. The funders had no influence in the identification, design, conduct, and reporting of the analysis.
publishDate 2023
dc.date.accessioned.fl_str_mv 2023-05-24T02:17:54Z
dc.date.available.fl_str_mv 2023-05-24T02:17:54Z
dc.date.issued.fl_str_mv 2023
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv SOUZA, Fabrine C. et al. Evaluation of labor and childbirth care by nurse-midwives in Brazilian private hospitals: results of a quality improvement project. Reproductive Health, v. 20, Suppl. 2, p. 1-12, Jan. 2023.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/58602
dc.identifier.issn.en_US.fl_str_mv 1742-4755
dc.identifier.doi.none.fl_str_mv 10.1186/s12978-022-01537-0
dc.identifier.eissn.none.fl_str_mv 1742-4755
identifier_str_mv SOUZA, Fabrine C. et al. Evaluation of labor and childbirth care by nurse-midwives in Brazilian private hospitals: results of a quality improvement project. Reproductive Health, v. 20, Suppl. 2, p. 1-12, Jan. 2023.
1742-4755
10.1186/s12978-022-01537-0
url https://www.arca.fiocruz.br/handle/icict/58602
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
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instname_str Fundação Oswaldo Cruz (FIOCRUZ)
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collection Repositório Institucional da FIOCRUZ (ARCA)
bitstream.url.fl_str_mv https://www.arca.fiocruz.br/bitstream/icict/58602/1/license.txt
https://www.arca.fiocruz.br/bitstream/icict/58602/2/ve_Fabrine_Souza_etal_ENSP_INI_2023.pdf
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