PREVIEW NOTES

Nursing guidelines with regard to high-risk pregnancy: a descriptive study

Rosangela de Oliveira Azevedo¹, Zenith Rosa Silvino¹, Helen Campos Ferreira¹

¹Fluminense Federal University

ABSTRACT
Aim: To describe the profiles of women with high-risk pregnancy receiving hospital treatment so as to provide nursing care procedure guidelines in order to improve the quality of care. To identify some relevant and adequate nursing procedures for dealing with pregnant women in hospital; to develop guidelines on how the healthcare providers should handle high-risk pregnancy.
Method: this is a descriptive exploratory study using a qualitative approach. It involves documentary analysis, non-participant observation, and questionnaire to gather information from the nursing team members of a University Hospital which is reference in high-risk pregnancies. The participants will be nurses, nurse technicians and nursing assistants who provide direct assistance to the patients. The data collected will be analyzed using descriptive statistics and the discussion will be based on the literature on models of healthcare for women with high-risk pregnancies.
Descriptors: Pregnant Women; Pregnancy, High-risk; Nursing Assessment

SITUATION PROBLEM AND ITS SIGNIFICANCE

It is challenging for healthcare providers to deliver high-quality assistance for high-risk pregnant women, taking into account the high rates of death among such women, which is a problem not only for society, but also for the health authorities. The healthcare procedures followed at the hospital under consideration aim to identify potential health complications that may put the mothers’ and babies’ health at risk. For this purpose, the use of tools to help recommend and provide specific care becomes utterly necessary. Choosing an adequate care procedure and intervention for cases such as high-risk pregnancies depends on the problem presented, which means that there are no set procedures⁽¹⁾. The Heath Ministry defines high-risk pregnancy as a health condition which puts the mother’s or child’s life at risk⁽²⁾, and also establishes a classification of obstetric risk that requires quick decision-making on the part of the healthcare professionals in order to prevent the mother and child dying⁽³⁾.  This study will be conducted at Antonio Pedro University Hospital (HUAP) and, as national guidelines are not specific, it intends to deal with the cases as they occur.  Healthcare management is essential when it comes to the mother’s and child’s welfare; therefore, in order to provide an efficient care service, the nursing procedures must be based on the profile of the high-risk pregnant women admitted to the hospital, since they are singular patients in a specific context.

GUIDING QUESTION

How do we establish guidelines with regard to nursing care procedures for women with high-risk pregnancy at HUAP, taking into consideration their singular context?

ASSUMPTION

This study assumes that the nursing care provided to women with high-risk pregnancy at HUAP has to be systematized by guidelines in order to improve the quality of the care service delivered.  

AIMS

To describe the profile of high-risk pregnant women receiving treatment at the hospital so as to provide guidelines with regard to nursing care procedures in order to improve the care service;
to identify some relevant and adequate nursing procedures for dealing with pregnant women in hospital;
to develop guidelines on how the healthcare providers should handle high-risk pregnancies.

METHOD

This is a descriptive exploratory study using a qualitative approach. It will involve the analysis of medical reports, questionnaires to gather information from the nursing team, and non-participant observation of the nursing procedures from the initial reception and patient condition assessment to the procedures followed by the nursing team when they deal with mothers and their families.  The participants will be 30 healthcare professionals and will include nurses, nurse technicians, and nursing assistants. The inclusion criteria are as follows: to be a member of the nursing team who provides a direct service to high-risk pregnant women receiving treatment at the HUAP. The exclusion criteria are: professionals who are absent from work due to illness during the data collection period.

It is expected that the guidelines with regard to high-risk pregnancy will help the nursing team members to identify potential threats to the pregnant women’s health more quickly and efficiently than in the case at present. The data will be analyzed using descriptive statistics and the discussion will be based on the literature on models of healthcare for high-risk pregnant women with high-risk pregnancy. This project has been approved by the IRB of the Fluminense Federal University under CAAE protocol no. 10980413.7.0000.5243, and complies with the resolution no. 466/12.  Although this study does not intend to promote any kind of risk to the mothers or to the professionals involved, in the event of any risk, the nursing team, especially the senior nurse, will be immediately called out to deal with any problem that might have occurred. This study will preserve the anonymity of the research participants and the confidentiality of the data collected.

REFERENCES

1. Ministério da Saúde, Secretaria de Atenção a Saúde. Gestação de Alto Risco. Brasília: Ministério da Saúde; 2010.

2. Gomes ML. Enfermagem obstétrica: diretrizes assistenciais. Rio de Janeiro: Centro de Estudos da Faculdade de Enfermagem da Universidade do Estado do Rio de Janeiro; 2010.

3. Moraes JL, Oliveira AS, Herculano MMS, Costa CC, Damasceno AKC. Prevalence hypertensive syndrome gestational in maternity reference: descriptive study. Online braz J nurs [ Internet ]. 2010 Sept [ Cited 2013 Aug 28 ] 9 (2): [ about 7 p. ]. Available from: http://www.objnursing.uff.br/index.php/nursing/article/view/2971 http://dx.doi.org/10.5935/1676-4285.20102971

Project Data
Dissertation Project Program Professional Master in Nursing Care
Approved by the IRB of the Fluminense Federal University under CAAE protocol no. 10980413.7.0000.5243
Advisor: Prof. Dr. Zenith Rosa Silvino
Co-advisor: Helen Campos Ferreira

Received: 28/08/2013
Revised: 29/08/2013
Approved: 30/08/2013