Obstetric Nurses Research Articles

A história da formação profissional de enfermeiras obstétricas em Minas Gerais (1957-1999): uma análise genealógica

to analyze obstetric nurses' professional training in Minas Gerais between 1957 and 1999, according to genealogical principles. a qualitative interpretative study based on historical research with genealogical analysis. Data were obtained through documentary research and oral history, with six participants, and submitted to discourse analysis. they recompose the genealogical path of obstetric nurses' professional training from Minas. The speeches reveal field of practice deprivation in professional training and the importance of the articulation between the Universidade Federal de Minas Gerais Nursing School and Hospital Sofia Feldman for teaching and work in obstetric nursing. It was identified that training, in the national scenario, evolved from a Escola de Enfermagem Carlos Chagas' peripheral initiative to centrality and capillarity. the unique historical trajectory of obstetric nurses' professional training in Minas Gerais, marked by ruptures, institutional articulations, conflicting games and interest, was unveiled.

Professional autonomy in dealing with complications: discourse of obstetric nurses working in planned home births.

to understand the exercise of professional autonomy by obstetric nurses in dealing with complications in planned home births. this is a qualitative study, supported by the Discourse of the Collective Subject methodological framework, whose data collection took place from January to March 2021, through interviews guided by a semi-structured script, in which seven midwives who are members of a childbirth care collective in northeastern Brazil and who work in the home context participated. four central ideas emerged from the collective discourses related to the exercise of professional autonomy by obstetric nurses: shared decisions; theoretical-practical instrumentalization; professional expertise; and teamwork. obstetric nurses' autonomy in the face of complications reflects the safety of planned home births and is based on collective critical thinking, reinforcing this professional' leading role in obstetrics.

CULTURA DE SEGURANÇA NA PRÁTICA CLÍNICA DOS ENFERMEIROS OBSTETRAS

ABSTRACT Objective: to identify the safety culture dimensions that influence obstetric nurses’ clinical practice. Method: an observational, analytical and cross-sectional study, carried out from September 2018 to May 2019 at two maternity hospitals integrated in a hospital center in the Central region of Portugal. A total of 70 obstetric nurses answered the Hospital Survey on Patient Safety Culture. The data were submitted to descriptive and inferential analysis. The dimensions were considered strong when they presented scores ≥ 75.0% of positive answers, and deemed as problematic with scores ≤ 50.0%. Results: the “Teamwork within units” dimension was the one that obtained scores above 75.0%. The “Supervisor expectations”, “Feedback and communication about errors”, “Communication openness”, “Organizational learning” and “Hospital handoffs and transitions” dimensions obtained scores between 50.0% and 65.0%. The “Non-punitive response to error”, “Frequency of events reported”, “Management support for patient safety” and “Staffing” dimensions had scores below 40.0%. Conclusion: the results of this study show that “Teamwork within units” is a strong safety culture dimension in maternity hospitals. However, the prevalence of a punitive culture, underreporting of adverse events, insufficient number of obstetrical nurses and little commitment of the hospital management are considered as problematic dimensions that influence obstetric nurses' practice. This assessment of the safety culture contributes to planning interventions that reduce the incidence of errors and improve the safety of obstetric care.

Medidas não farmacológicas para alívio da dor do parto: revisão sistemática

Abstract Objectives: to evaluate the effectiveness of non-pharmacological measures used by obstetric nurses to relieve pain during labor. Methods: this is a systematic review of the databases carried out in the United States National Library of Medicine, Cumulative Index to Nursing and Allied Heal Literature, Scopus, Web of Science and Latin American and Caribbean Literature in Health Sciences, the descriptors were: labor pain, labor, obstetric and obstetric nursing. The search and selection followed the PRISMA recommendations, were carried out from August to September 2020, and randomized clinical trials were eligible and analyzed using descriptive statistics. Results: 17 clinical trials made up the final sample, which highlight the use of non-pharmacological measures with diversified benefits for labor, namely: thermal therapy (20%); massage/sacral massage (15%); Swiss ball exercises (15%); acupressure (15%); auriculotherapy (10%); music therapy (10%); aromatherapy (5%); acupuncture (5%); and dance (5%). Conclusion: the non-pharmacological measures found in this review are efficient to promote pain reduction during labor, associated with a decrease in the use of drug interventions.

LIBERDADE DE MOVIMENTOS E POSICIONAMENTOS NO PARTO COM AS TECNOLOGIAS NÃO INVASIVAS DE CUIDADO DE ENFERMAGEM

ABSTRACT Objective: to identify the non-invasive technologies and care strategies used by obstetric nurses to encourage freedom of movement and positioning in the parturition process. Method: A descriptive and qualitative study, with 20 obstetric nurses working in public obstetric services in Rio de Janeiro - Brazil. Data were collected from May to July 2021 through semi-structured interviews and submitted to thematic analysis. Results: the participants use the encouragement to ambulate and perform pelvic movements and squats, also suggesting specific positions, especially vertical ones. As strategies, they orient about the benefits of these technologies and respect the choice of the expectant women, interfering, however, in cases of obstetric complications. Conclusion: The incentive to freedom of movement and positioning in parturition happens with the offer of different non-invasive technologies in a care relationship with clarified and shared decision-making processes, which promote autonomy and ensure the right to safe and respectful assistance.

Retracted: Research on Cognition and Training Needs of Sex Education during Pregnancy among Obstetricians and Obstetric Nurses in Guangdong Province Based on Mixed Research Perspective.

[This retracts the article DOI: 10.1155/2022/2536849.].

A identidade da enfermagem obstétrica no centro de parto normal

Abstract Objective to understand obstetrical nursing identity in the area of its performance in a Birth Center. Method a descriptive-exploratory study with a qualitative approach. Semi-structured interviews were carried out between March and August 2022 with 09 nurse-midwives from the Centro de Parto Normal Haydeê Pereira Sena, Pará, Brazil. Content analysis and discussion based on Claude Dubar’s identity were used. Results two categories emerged: Professional identity: a matter of social construction, which portrays the social scope of identity construction through experiences as a student and as a nurse and their relationships in the work process; and The identity of obstetrical nursing in the field of its performance in a Birth Center, favoring humanization, scientific evidence for women’s autonomy, which is only provided by the birth center’s structuring policy, and coping with other professional classes, to guarantee and legitimize nurse-midwives’ work. Conclusion and implications for practice understanding nurses’ professional identity in the birth center is the central point to ensure their appreciation and their performance with respect, legitimizing their right, because, with a solid identity, greater quality and changes in the hegemonic obstetric model are guaranteed.

Implementing an Undergraduate Nursing Elective Advanced Perinatal Course and Its Effect on Perceived Perinatal Nursing Knowledge and Self-Efficacy Levels of Students Who Aim to Enter a Perinatal Specialty as New Graduate Nurses

Nursing schools face challenges within maternal/newborn practicum courses for undergraduate nursing students, such as a lack of consistent clinical sites or experiences that capture the high acuity needs of perinatal environments. Additionally, perinatal units face challenges in orienting and retaining new graduate nurses, while new graduate nurses entering perinatal units may be likely to experience feelings of insecurity or self-doubt due to perceived inadequate preparation for such specialties (Lesher et al., 2021). There are multiple negative impacts that may stem from a lack of confident and competent novice perinatal nurses. The rise in maternal morbidity and mortality rates in the United States are of particular concern, and knowledge gaps on behalf of novice perinatal nurses may result in the lack of skills and confidence in recognizing complications and intervening appropriately, potentially jeopardizing patient safety. The literature suggests that perinatal units face challenges in effectively orientating new graduate nurses, leading to burnout and financial burdens (Dickerson et al., 2022). Recognizing the potential benefits of improving preparation for students interested in entering a perinatal specialty as new graduates, such as improved patient outcomes and increased staff retention, this study aims to analyze the impact of an elective advanced perinatal course on student perception of knowledge and self-efficacy levels for those who aim to enter a perinatal specialty as a new graduate nurse. Content will be focused on advancing knowledge of normal physiologic birth, high-risk obstetrical and newborn considerations, obstetric emergencies, perinatal mood and anxiety disorders, bereavement care, diversity/equity/inclusion care, and resiliency tips.

EVENTOS ADVERSOS OBSTÉTRICOS E NEONATAIS E ASSOCIAÇÃO COM OS MODELOS DE ASSISTÊNCIA: UM ESTUDO COORTE

ABSTRACT Objective: to analyze the prevalence of practices in childbirth care, obstetric and neonatal adverse events and their association with care models in three public health services. Method: this is a prospective cohort study carried out with 548 dyads, postpartum women and their newborns, whose pregnancy was of usual risk and vaginal birth, admitted to hospital in three public services, one with an exclusive care model by nurse-midwives (service A), one with a collaborative model involving obstetric doctors and nurses (service B) and one with an exclusive medical care model (service C). Initially, an interview was carried out with participants, and a second contact was carried out 42 days after birth to complement the collection of the adverse event outcome. Results: in service A, no woman underwent the Kristeller maneuver, episiotomy, directed pushing or more than one vaginal examination per hour. Meanwhile, in service C, 19.3%, 39.9%, 77.1% and 26.3% of women underwent these interventions, respectively. Adverse events occurred in 19.2% of the dyads. Occurrence of adverse events was associated with not using partograph (p=0.001; OR: 11.03; CI: 2.64-45.99) and episiotomy (p=0.042; OR: 1.72; CI: 1. 02-2.91). The mean probability of experiencing an adverse event was 5% in service A, 21% in service B and 24% in service C. Conclusion: adverse events had a lower mean probability of occurrence in the service exclusively operated by nurse-midwives, in which greater application of recommendations for labor and birth care was identified.

Retracted: Building and Realizing the Obstetrics and Gynecology Nursing Management Platform by Computer Information Technology under the Concept of Mindfulness Intervention.

[This retracts the article DOI: 10.1155/2022/6297934.].

Outcomes of Intrauterine Device Insertion by Certified Midwives and Obstetric Nurse Practitioners.

to evaluate the outcomes of Interval Copper Intrauterine Device (IUD) insertion performed by certified midwives and obstetric nurse practitioners at a Peri-Hospital Birth Center. a cross-sectional study was conducted involving 75 women who underwent IUD insertion between January 2018 and February 2020. Data collection was carried out using medical records and telephone interviews. no instances of uterine perforation were observed. Expulsion rates of the devices were 1.3% within 30 to 45 days of use and 5.3% within the first year of use. The follow-up removal rate was 4.0%. The average pain score reported was 4.2 (SD = 3.3). Among those who continued using the device, 93.1% expressed satisfaction. the findings demonstrate that IUD insertion by certified midwives and obstetric nurse practitioners is a safe procedure, yielding outcomes comparable to those reported in the existing literature.

The history of obstetric nurses’ professional training of in Minas Gerais (1957-1999): a genealogical analysis

RESUMO Objetivos: analisar a formação profissional de enfermeiras obstétricas, em Minas Gerais, entre 1957 e 1999, segundo os princípios genealógicos. Métodos: estudo qualitativo interpretativo, fundamentado na pesquisa histórica com análise genealógica. Os dados foram obtidos por pesquisa documental e história oral, com seis participantes, e submetidos à análise do discurso. Resultados: recompõem o percurso genealógico da formação profissional das enfermeiras obstétricas mineiras. Os discursos revelam privação do campo de atuação prática na formação das profissionais e importância da articulação da Escola de Enfermagem da Universidade Federal de Minas Gerais e do Hospital Sofia Feldman para ensino e atuação da enfermagem obstétrica. Identificou-se que a formação, no cenário nacional, evoluiu de uma iniciativa periférica da Escola de Enfermagem Carlos Chagas para a centralidade e capilaridade. Considerações Finais: desvelou-se a trajetória histórica singular da formação profissional de enfermeiras obstétricas, em Minas Gerais, marcada por rupturas, articulações institucionais, jogos de enfrentamento e interesse.

Safe Newborn Sleep Practices on a Large Volume Maternity Service.

Reinforcing safe infant sleep conditions in the hospital setting supports continuation of safe sleep practices after hospital discharge and should be considered the first line of defense for reducing risk for sudden unexpected infant death (SUID) and sudden infant death syndrome (SIDS) at home. The purpose of this study is to determine knowledge of perinatal nurses, nursing assistants, physicians, and ancillary personnel about safe sleep recommendations and implementation of safe sleep practices on the mother-baby unit. Nurses and other members of the perinatal health care team in a level III maternity service were invited to participate in a survey about safe sleep knowledge and practices. An audit for safe sleep adherence was conducted on the mother-baby unit for 120 mother-baby couplets over 1 year as a process improvement project. N = 144 surveys were completed; most participants (86%) were nurses. They had high levels of knowledge about safe sleep recommendations and 74% reported making at least one safe sleep adjustment during one shift per week. The most common modifications at least once per week were removing baby from a sleeping caregiver (30%) and removing items from baby's bassinet (26%). Safe sleep audit findings revealed 32 out of 120 couplets were not fully following safe sleep recommendations, with most common unsafe sleep practice metrics being items in the baby's bassinet (18%) and bassinets propped up (8%). During the hospitalization for childbirth, new parents can learn about safe sleep practices from the perinatal health care team. Sharing information and role modeling safe sleep practices can promote continuation of safe sleep practices for the newborn at home after hospital discharge.

Lactation Accommodations in the Workplace.

Dr. Diane L. Spatz is a Professor of Perinatal Nursing and the Helen M. Shearer Professor of Nutrition at the University of Pennsylvania School of Nursing and a Nurse Scientist in the Center for Pediatric Nursing Research and Evidence Based Practice and Children's Hospital of Philadelphia. Dr. Spatz can be reached via email at [email protected] The author declares no conflicts of interest.

Exploring Nursing Undergraduates' Experiences with a Redesigned Blended Learning Course: A Descriptive Qualitative Study.

To explore the experience of nursing undergraduates with a blended course, that was redesigned using the Community of Inquiry framework. The Obstetrics and Gynaecology Nursing Course was redesigned using blended learning pedagogy, which starts from the creation of teaching presence, plays the intermediary role of social presence and aims at realizing cognitive presence. After the course completion, we conducted a qualitative descriptive study and collected data using focus group interviews and field notes. The findings comprised three main themes including role promotion, passive and selective learning and recommendations. Teachers and peers reportedly played the supervisors, facilitators and coordinators in learning promotion. Some students experienced difficulties in adapting to the blended learning environment due to passive learning habits, character flaws and academic pressure. However, a majority of them supported the application of the model.

Trauma-informed care for perinatal women during the COVID-19 pandemic: A survey of nurses and midwives in Turkey

ObjectivesThere is a paucity of evidence on the provision of trauma-informed care among nurses and midwives during the pandemic.Therefore, this online survey of Turkish nurses and midwives aimed to: describe reported maternal concerns and anxieties during the COVID-19 pandemic; and explore aspects of trauma-informed care for perinatal women during the COVID-19 pandemic (i.e., nurses’ and midwives’ knowledge, opinions, perceived competence, current practices, and implementation barriers). DesignA cross-sectional descriptive survey design. Setting and participantsA web-based survey conducted between June 2021 to December 2021. A total of 102 nurses and midwives comprised the final sample of this study. FindingsThe safety of COVID-19 vaccine was both the most common maternal concern (73%) and the most frequently noted maternal source of anxiety (79%) reported to nurses and midwives by perinatal women. Most nurses and midwives were knowledgeable of, held favorable opinion about, and perceived moderate competence in trauma-informed care. The most frequently provided practice was encouraging mothers to make use of their own social support system (82%). Time constrains and lack of resources were perceived as somewhat to significant barriers to providing trauma-informed care during the pandemic. ConclusionsAccess to correct information related to COVID-19 vaccination is necessary to reduce maternal anxiety. Since perinatal nurses and midwives had favorable opinions concerning implementing trauma-informed care, successful strategies for mitigating the implementation barriers are essential to facilitate the provision of trauma-informed care during the pandemic.

Obstetric Nurses' Self-Efficacy, Demographic Characteristics, and Family-Focused Care During Simulated Events.

Introduction/Background: A study involving 48 obstetric nurses explored the relationship between self-efficacy scores and demographic variables, and family-focused care during obstetrical emergencies. Methods: Obstetric Nursing Self-Efficacy Scale scores and demographic data were collected, and the Van Gelderen Family Care Rubric (VGFCR) was administered following simulation of obstetrical emergencies. Results: Two variables were found to influence the VGFCR scores. Nursing specialty certification and previous education in family-focused care. Conclusion: Improvements in the delivery of family-focused care can be achieved with simulation education and nursing specialty certification achievement.

Establishment of a model for predicting the outcome of induced labor in full-term pregnancy based on machine learning algorithm

To evaluate and establish a prediction model of the outcome of induced labor based on machine learning algorithm. This was a cross-sectional design. The subjects were divided into primipara and multipara, and the risk factors for the outcomes of induced labor were assessed by multifactor logistic regression analysis. The outcome model of labor induced with oxytocin (OT) was constructed based on the four machine learning algorithms, including AdaBoost, logistic regression, naive Bayes classifier, and support vector machine. Factors, such as accuracy, recall, precision, F1 value, and receiver operating characteristic curve, were used to evaluate the prediction performance of the model, and the clinical application of the model was verified. A total of 907 participants were included in this study. Logistic regression algorithm obtained better results in both primipara and multipara groups compared to the other three models. The accuracy of the model for the prediction of “successful induction of labor” was 94.24% and 96.55%, and that of “failed induction of labor” was 65.00% and 66.67% in the primipara and the multipara groups, respectively. This study established a prediction model of OT-induced labor based on the Logistic regression algorithm, with rapid response, high accuracy, and strong extrapolation, which was critical for obstetric clinical nursing.

AWHONN postpartum discharge education: patient knowledge and sustainability

ObjectiveThe objective is to evaluate whether the implementation of the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) postpartum discharge educational initiative is associated with improved patient knowledge of...

Treatment of Low Milk Supply.

Dr. Diane L. Spatz is a Professor of Perinatal Nursing and the Helen M. Shearer Professor of Nutrition at the University of Pennsylvania School of Nursing and a Nurse Scientist in the Center for Pediatric Nursing Research and Evidence Based Practice and Children's Hospital of Philadelphia. Dr. Spatz can be reached via email at [email protected] The author declares no conflicts of interest.