Eventos adversos obstétricos e neonatais e assiciação com os modelos de assitência: vídeo para incentivo ao uso de boas práticas

Abstract

Assistance to labor and birth has improved with the implementation of good practices based on scientific evidence. However, there are still limitations to its application by professionals who perform practices not recommended in labor and birth, thus favoring the occurrence of adverse events. Objectives: To analyze the prevalence of adverse events and their association with models of obstetric and neonatal care in public health services in the Federal District and, based on this, to develop a video to encourage greater adherence to good practices in obstetric care and reduction of adverse events. Method: Prospective cohort study with 651 puerperae whose labor was of usual risk, hospitalized in the rooming-in of three public health services of the Federal District, one with an exclusive care model by obstetric nurses (service A), one with a collaborative care model with the performance of physicians and obstetric nurses (service B) and a medical exclusive care model (service C). In the first contact with the puerperae, between April and August 2019, a face-to-face interview guided by a data collection instrument was conducted. The second contact was made 42 days after delivery by telephone contact, to collect the outcome, defined as the occurrence or not of any adverse event with her and her baby since delivery. Results: Adverse events occurred in 20.1% of puerperae and were associated with not using the partogram (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 average probability of presenting some adverse event was 5% in service A, 21% in service B and 24% in service C. Product developed: video to encourage greater adherence to good obstetric care practices and reduction of adverse events. Conclusion: the use of good practices occurs effectively in service A, reinforcing that the obstetric nurses' assistance during labor and birth comply with the recommendations for good practices and consequently favor a lower occurrence of adverse events.