Implantação do protocolo de assistência ao parto e nascimento: pimeiro passo para uma assistência uniforme de qualidade Hospital Municipal Coluna

Abstract

Clinical Protocols are documents directed to health professionals that aim to guarantee care based on scientific evidence and can be used as educational material, administrative assistance to managers, a parameter of care practices based on scientific evidence and a document of guaranteeing rights to users of SUS. Recent studies indicate that those in institutions that use clinical protocols for childbirth care, especially in high-risk pregnancies, as conduit counselors, present lower cesarean rates and unnecessary interventions. This project will be developed at the Municipal Hospital Agostinha Alcântara Aguiar (HMAAA), located in the municipality of Coluna, Minas Gerais. It is a small hospital, with 100% SUS care, with capacity for 38 beds. Objectives: To implement the Birth and Birth Assistance Protocol at Agostinha Alcântara Aguiar Municipal Hospital, as well as to standardize the care offered to pregnant women entering the maternity sector and to provide care for childbirth and birth based on scientific evidence. Target audience: The health secretary, the technical and administrative directors of the hospital, as well as the medical staff and nursing staff and all women and their newborns attended at the institution. Methodological strategies: It is an intervention project, which seeks to implement the Protocol of Assistance to Childbirth and Birth at the Municipal Hospital Agostinha Alcântara Aguiar, following the following steps: 1- Realization of a bibliographic review for scientific basis of the project; 2- Reading of protocols of Assistance to childbirth and birth of institutions of reference of the region of Vale do Jequitinhonha and Belo Horizonte; 3- Presentation of the Project of intervention for the managers of the institution; 4- Presentation of the project for the medical and nursing team; 5- Elaboration of the Protocol of Assistance to Childbirth and Birth, taking into account the reality of our institution, considering human resources, materials and medicines available; 6- Validation of the Protocol of Assistance to Childbirth and Birth by all staff working in childbirth care; 7- Training for all employees who will deal directly with the protocol. Evaluative follow-up: The evaluation of this project is carried out in a continuous way, by means of conversation with the maternity workers and direct observation of the childbirth assistance offered at the institution, thus, the following results have already been achieved: 1- Implementation of the partogram; 2- Implementation of the rapid tests for syphilis and HIV; 3- Humanization of labor, through the use of non-pharmacological methods for pain relief (shower, massage, ball); 4- Soft and liquid diet released during labor; 5- Presence of companion during childbirth; 6- Skin-to-skin contact; 7- First care with NB after one (1) hour of life and bath after 24 hours; 8- Creation of a folder with guidelines for pregnant women; 9- Greater openness of doctors to discuss conducts; 10- Postpartum evaluation of postpartum women; 11- Leaf delivery with guidelines on care in the normal postpartum and cesarean delivery at the time of hospital discharge; 12- Reduction of the indiscriminate use of formula; 13- Stimulus to breastfeeding in the first hour of life.