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South African Medical Journal =... Mar 2019The institutional maternal mortality ratio (iMMR) in South Africa (SA) is still unacceptably high. A key recommendation from the National Committee on Confidential... (Observational Study)
Observational Study
BACKGROUND
The institutional maternal mortality ratio (iMMR) in South Africa (SA) is still unacceptably high. A key recommendation from the National Committee on Confidential Enquiries into Maternal Deaths has been to improve the availability and quality of care for women suffering obstetric emergencies.
OBJECTIVES
To determine whether there was a change in the number of maternal deaths and in the iMMR over time that could be attributed to the training of >80% of healthcare professionals by means of a specifically designed emergency obstetric care (EmOC) training programme.
METHODS
A before-and-after study was conducted in 12 healthcare districts in SA, with the remaining 40 districts serving as a comparison group. Twelve 'most-in-need' healthcare districts in SA were selected using a composite scoring system. Multiprofessional skills-and-drills workshops were held off-site using the Essential Steps in Managing Obstetric Emergencies and Emergency Obstetric Simulation Training programme. Eighty percent or more of healthcare professionals providing maternity care in each district were trained between October 2012 and March 2015. Institutional births and maternal deaths were assessed for the period January 2011 - December 2016 and a before-and-after-training comparison was made. The number of maternal deaths and the iMMR were used as outcome measures.
RESULTS
A total of 3 237 healthcare professionals were trained at 346 workshops. In all, 1 248 333 live births and 2 212 maternal deaths were identified and reviewed for cause of death as part of the SA confidential enquiries. During the same period there were 5 961 maternal deaths and 5 439 870 live births in the remaining 40 districts. Significant reductions of 29.3% in the number of maternal deaths (risk ratio (RR) 0.71, 95% confidence interval (CI) 0.66 - 0.77) and 17.5% in the number of maternal deaths from direct obstetric causes (RR 0.825, 95% CI 0.73 - 0.93) were recorded. When comparing the percentage change in iMMR for equivalent before-and-after periods, there was a greater reduction in all categories of causes of maternal death in the intervention districts than in the comparison districts.
CONCLUSIONS
Implementing a skills-and-drills EmOC training package was associated with a significant reduction in maternal deaths.
Topics: Clinical Competence; Delivery, Obstetric; Education, Medical, Continuing; Education, Nursing, Continuing; Emergencies; Emergency Medical Services; Female; Humans; Maternal Death; Obstetric Labor Complications; Pregnancy; Quality Improvement; Quality Indicators, Health Care; Simulation Training; South Africa
PubMed: 31084689
DOI: 10.7196/SAMJ.2019.v109i4.13578 -
Asian Nursing Research Jun 2016The purpose of this study was to explore how traditional ritual practices are incorporated into the context of contemporary healthcare.
PURPOSE
The purpose of this study was to explore how traditional ritual practices are incorporated into the context of contemporary healthcare.
METHODS
An ethnographic study was conducted, using observations and interviews with 27 first-time mothers and 3 nurses at a postpartum nursing center in Taipei, Taiwan.
RESULTS
Nursing routines, policies and care provision at the center affected the way traditional ritual practices were conducted. New mothers in this study constructed their everyday activities at the center by incorporating and modifying the ritual practices inside and outside the postpartum nursing center setting.
CONCLUSIONS
Social changes have an influence on traditional postpartum ritual practices so a postpartum nursing center becomes a choice for postpartum women. Thus, health care professionals should value their own functions and roles at the postpartum nursing center since the new mothers regard them as the primary support resource to help them recover from giving birth. Therefore, they need to re-examine their practices from the postpartum women's perspective to provide better support and sensitive care to postpartum women and their families.
Topics: Adult; Ambulatory Care Facilities; Attitude of Health Personnel; Education, Nonprofessional; Female; Humans; Length of Stay; Medicine, Chinese Traditional; Mothers; Nurse's Role; Nursing Process; Obstetric Nursing; Postnatal Care; Postpartum Period; Taiwan
PubMed: 27349665
DOI: 10.1016/j.anr.2016.03.001 -
BMC Pregnancy and Childbirth Jan 2017The partograph (or partogram) is recommended by the World Health Organisation (WHO), for monitoring labour wellbeing and progress. Concerns about limitations in the way... (Review)
Review
BACKGROUND
The partograph (or partogram) is recommended by the World Health Organisation (WHO), for monitoring labour wellbeing and progress. Concerns about limitations in the way the partograph is used in the clinical context and the potential impact on its effectiveness have led to this realist systematic review of partograph use.
METHODS
This review aimed to answer two key questions, 1) What is it about the partograph that works (or does not work); for whom does it work; and in what circumstances? 2) What are the essential inputs required for the partograph to work? A comprehensive search strategy encompassed key databases; including papers of varying methodologies. Papers were selected for inclusion if the focus of the paper was the partograph and related to context, mechanism or outcome. Ninety five papers were included for data synthesis. Two authors completed data extraction and synthesis.
RESULTS
The evidence synthesis relates the evidence to identified theories of health worker acceptability, health system support, effective referral systems, human resources and health worker competence, highlighting barriers and facilitators.
CONCLUSIONS
This first comprehensive realist synthesis of the partograph, provides the international community of maternity clinicians with a picture of potential issues and solutions related to successful labour recording and management, which is also translatable to other monitoring approaches.
Topics: Female; Fetal Monitoring; Humans; Labor, Obstetric; Obstetric Labor Complications; Pregnancy; Uterine Monitoring
PubMed: 28086823
DOI: 10.1186/s12884-016-1213-4 -
Frontiers in Public Health 2018For exploring maternal death, supply and demand-side factors can be characterized by the three delays model developed by Thaddeus and Maine (1994). The model comprises...
BACKGROUND
For exploring maternal death, supply and demand-side factors can be characterized by the three delays model developed by Thaddeus and Maine (1994). The model comprises delay in deciding to seek care (delay 1), delay in reaching the health facility (delay 2), and delay in receiving quality care once at the health facility (delay 3). Few studies have comprehensively dealt with the health systems delays that prevent the receipt of timely and appropriate obstetric care once a woman reaches a health facility (phase III delays). The objective of the present study was to identify facility-level barriers in West African health facilities.
METHODS
Electronic databases (Medline, cumulative index to nursing and allied health literature, Centre for Agriculture and Biosciences International Global Health, EMBASE) were searched to identify original research articles from 1996 to 2016. Search terms (and synonyms) related to (1) maternal health care (e.g., obstetric care, perinatal care, maternal health services); (2) facility level (e.g., maternity unit, health facility, phase III, hospital); and (3) Western Africa (e.g., Nigeria, Burkina Faso) were combined. This review followed the preferred reporting items for systematic reviews and meta-analyses.
RESULTS
Of the 2103 citations identified, 13 studies were eligible. Studies were conducted in Nigeria, Burkina Faso, Gambia, Guinea, Senegal, and Sierra Leone. 30 facility-level barriers were identified and grouped into 6 themes (human resources, supply and equipment, referral-related, infrastructure, cost-related, patient-related). The most obvious barriers included staff shortages, lack of maternal health services and procedures offered to patients, and lack of necessary medical equipment and supplies in the health-care facilities.
CONCLUSION
This review emphasizes that phase I and phase II barriers are not the only factors preventing women from accessing proper emergency obstetric care. Health-care facilities in Western Africa are inadequately equipped to handle the obstetric needs of patients. Supply-side barriers must be addressed to reduce maternal mortality in the region.
PubMed: 29535999
DOI: 10.3389/fpubh.2018.00048 -
Revista Brasileira de Enfermagem 2010The objective of this bibliographic study is to identify the state of the art of production published in the area of obstetrics nursing involving the birth process, to... (Review)
Review
The objective of this bibliographic study is to identify the state of the art of production published in the area of obstetrics nursing involving the birth process, to contribute to future investigations, and to assist in reflection upon this theme. Data was collected through the bibliographic analysis of the LILACS, MEDLINE, Cochrane Library, and SciELO databases. Descriptors used: nurse-midwives, childbirth work, normal childbirth, and Nursing care. Five studies were selected and later catalogued in bibliographic files. The themes selected were: professional regulation, care, assistance given, link established, educational actions, administrative activities, and difficulties. While the studies recognize this professional as a capacitated, legally backed professional who offers humanized assistance and thus reaffirms normal vaginal delivery, thus proportioning dignity, security, and autonomy to the delivering mother much still needs to written in order for the same autonomy and ethical-legal respect is acquired for health care professionals and clientele.
Topics: Female; Humans; Labor, Obstetric; Obstetric Nursing; Pregnancy
PubMed: 20835673
DOI: 10.1590/s0034-71672010000400023 -
BMC Nursing Dec 2023Workplace violence severely impacts individual nurses. With the three-child opening policy of China and the impact of the COVID-19 epidemic in the recently years,...
Prevalence of workplace violence in Chinese obstetric nurses under the new situation and its correlation with violence prevention knowledge-attitude-practice and climate perception: a cross-sectional study.
BACKGROUND
Workplace violence severely impacts individual nurses. With the three-child opening policy of China and the impact of the COVID-19 epidemic in the recently years, obstetric nurses face the double attack of heavy workload and staffing shortage. This study aimed to evaluate the current situation of workplace violence among Chinese obstetric nurses under the new situation, assess the level of violence prevention knowledge-attitude-practice and climate perception in Chinese obstetric nurses and explore the correlation between workplace violence and the level of violence prevention knowledge-attitude-practice and climate perception.
METHODS
A cross-sectional survey on the workplace violence for Chinese obstetric nurses was conducted from August to February 2023. All the questionnaires came from 10 provinces and 3 autonomous regions in China. The basic characteristics of obstetric nurse's workplace violence, workplace violence prevention knowledge-attitude-practice scale and workplace violence climate perception scale were collected.
RESULTS
Totally, 522 Chinese obstetric nurses were included. 55.0% of obstetric nurses (287) had experienced workplace violence in the past 12 months, including verbal assault (40.4%), physical assault (34.1%), and sexual assault (31.0%). The overall level of obstetric nurses' workplace violence prevention knowledge-attitude-practice and climate perception of workplace violence was low. Multiple linear regression analysis showed that the violence prevention knowledge dimension significantly influenced obstetric nurses' workplace violence (B = -0.278, P < .001), attitude dimension (B = -0.241, P < .001), behavior dimension (B = -0.216, P < .001) and the violence climate perception's organizational management (B = -0.177, P < .001), organizational training (B = -0.175, P < .001), organizational support (B = -0.143, p < .001) and the violence handling (B = -0.165, P < .001).
CONCLUSION
The incidence of workplace violence among obstetric nurses in the new situation is high. However, the overall violence prevention knowledge-attitude-practice and climate perception levels are low. Therefore, nursing managers should take targeted measures according to the relevant influencing factors and the characteristics of obstetrics to improve the level of obstetric nurses' violence prevention knowledge-attitude-practice and climate perception to reduce workplace violence among obstetric nurses.
PubMed: 38093351
DOI: 10.1186/s12912-023-01637-7 -
Revista Gaucha de Enfermagem 2022To characterize the stricto sensu scientific production of Brazilian nursing that resorts to phenomenological theoretical frameworks.
OBJECTIVE
To characterize the stricto sensu scientific production of Brazilian nursing that resorts to phenomenological theoretical frameworks.
METHOD
Descriptive, exploratory, and document study carried out using the CAPES catalog of theses and dissertations from January to April 2022.
RESULT
The sample included 600 dissertations and theses, with a predominance of the Heideggerian framework, followed by Schütz and Merleau-Ponty. Topics discussed included nursing care in women's health, mental health, pediatric and adolescent nursing, oncology nursing, obstetric nursing, Primary Health Care, as well as family and nursing education.
CONCLUSION
Phenomenology was found to be a powerful reference for the unveiling of the phenomena of interest to the field of nursing, contributing to the construction of knowledge about the being who cares, the being who is cared for, and the care itself.
Topics: Female; Humans; Child; Adolescent; Nursing Research; Brazil
PubMed: 36478016
DOI: 10.1590/1983-1447.2022.20220150.en -
Sexual & Reproductive Healthcare :... Jun 2021
Topics: Female; Humans; Labor, Obstetric; Parturition; Pregnancy
PubMed: 33774268
DOI: 10.1016/j.srhc.2021.100617 -
Korean Journal of Women Health Nursing Mar 2013This study was performed to propose an ontology methodology based on standardized nursing process as framework in obstetric and gynecologic nursing practice.
PURPOSE
This study was performed to propose an ontology methodology based on standardized nursing process as framework in obstetric and gynecologic nursing practice.
METHODS
The instrument used in this study was based on the nursing diagnosis classification established by North American Nursing Diagnosis Association (NANDA) (2009-2011), fifth edition of the Nursing Interventions Classification (NIC) (2008), forth edition of the Nursing Outcomes Classification (NOC) (2008) developed by Iowa State University and systematized nomenclature of medicine clinical terms (SNOMED CT). The nursing records data were collected from electronic medical records of one hospital from August to October 2010.
RESULTS
One hundred and forty-one nursing diagnosis statements used in obstetric and gynecologic nursing unit were linked standardized nursing classifications and constructed nursing diagnosis ontology including interoperability.
CONCLUSION
Not only will this result be helpful to complete nurse's lack of knowledge and experience, it will also help to determine nursing diagnosis logically by using standardized nursing process. It will be utilized as the method to construct ontology including interoperability in other nursing units. It will be presented nursing interventions according to nursing diagnosis and thus will be easier to establish nursing planning. This can provide immediate feedback of the nursing process application.
PubMed: 37684747
DOI: 10.4069/kjwhn.2013.19.1.1 -
Canadian Family Physician Medecin de... Jan 1997To learn which factors influencing perineal integrity were modifiable by physicians and pregnant women. (Review)
Review
OBJECTIVE
To learn which factors influencing perineal integrity were modifiable by physicians and pregnant women.
DATA SOURCES
Medical, nursing, and midwifery literature was searched mainly for randomized controlled trials.
STUDY SELECTION
We chose articles on perineal trauma pattern, sexual dysfunction or satisfaction, urinary incontinence, and pelvic floor function. We identified 80 papers and studied 16 in detail.
SYNTHESIS
Five factors affected perineal integrity: episiotomy, third-trimester perineal massage, mother's position in second-stage labour, method of pushing, and administration of epidural analgesia. Episiotomy does not improve perineal outcomes when used routinely. Third-trimester perineal massage was discussed only in inadequate studies. Studies comparing position in birth chairs and recumbent versus upright positions were inadequate for making firm recommendations. Studies of methods of pushing and use of epidural analgesia were limited and uncontrolled; no recommendations were possible.
CONCLUSION
Only limiting episiotomy can be strongly recommended. In the absence of strong data to the contrary, women should be encouraged to engage in perineal massage if they wish and to adopt the birth positions of their choice. Caretakers should be aware of the possibility of interfering with placental function when women hold their breath for a long time when pushing.
Topics: Delivery, Obstetric; Dyspareunia; Episiotomy; Female; Humans; Labor Stage, Second; Massage; Obstetric Labor Complications; Perineum; Posture; Pregnancy; Puerperal Disorders; Research Design; Treatment Outcome; Urinary Incontinence; Wounds, Penetrating
PubMed: 9626426
DOI: No ID Found