Avaliação da conformidade nas práticas assistenciais realizadas ao recém-nascido saudável na primeira hora de vida

• Autor(a) principal: Vieira, Janine Alencar Souza
• Data de Publicação: 2019
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Federal do Ceará (UFC)
• Texto Completo: http://www.repositorio.ufc.br/handle/riufc/45874
• topic: Recém-Nascido; Assistência Perinatal; Serviços de Saúde; Serviços de Saúde Materno-Infantil

Objective: To evaluate the conformity of care practices performed in the delivery room to healthy newborns in the first hour of life in a municipal maternity hospital in the northeast Brazilian capital. Methodology: Cross-sectional study. The conformity assessment comprised three groups, related to structural, organizational and practical aspects. The population consisted of healthy newborns assisted in the first hour of life and their respective mothers. The sample consisted of 234 deliveries, with direct observation of births and consultation of medical records to assess the conformity of practices, through a questionnaire built on national and international recommendations for good practice in neonatal care. Questionnaires were also administered to newborn care coordinators. A municipal reference maternity hospital in Fortaleza was chosen and data were collected from December 2018 to June 2019. Results: The hospital presented 75.4% conformity (Medium conformity) for good practices performed to the newborn in the first hour of life. Group 1, regarding infrastructure, human and material resources, achieved 92.5% conformity, and Group 2, regarding organizational processes, reached the highest score. The group with the highest variation was 3 (53.7%), which was related to care practices performed directly to the newborn. Recommended practices had high frequencies, such as timely umbilical cord clamping (96.2%), keeping the newborn in skin-to-skin contact with the parent (93.6%), and stimulus to the maternal breast in the delivery room (76,1%). However, inappropriate practices were also observed, such as airway aspiration (24.4%) and gastric content (21.8%), passage of nasogastric tube (23.5%) and rectal (1.7%), in addition to the use of inhaled oxygen (6.8%) and heated crib (86.8%). Other precautions that could be postponed, such as prophylaxis of hemorrhagic disease and neonatal ophthalmia and measurement of anthropometric data, also had a high frequency within the first hour of life. Conclusion: It was concluded that there were important variations in care practices performed to healthy newborns. The results point out that, despite good infrastructure conditions, material and human resources, as well as updated institutional protocols, the best practices have not been effectively incorporated into the service routines.