Banca de QUALIFICAÇÃO: KELIENNY DE MENESES SOUSA

Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.
STUDENT : KELIENNY DE MENESES SOUSA
DATE: 01/11/2019
TIME: 14:00
LOCAL: Departamento de Saúde Coletiva
TITLE:

QUALITY OF OBSTETRIC AND NEONATAL CARE: GOOD PRACTICES, ADVERSE EVENTS AND EFFECTS OF THE WHO SAFE CHILDBIERTH CHECKLIST

KEY WORDS:

Quality of Health Care. Patient Safety. Maternal-Child Health Services. Checklist 

PAGES: 205
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUMMARY:

Introduction: Although it is a natural process, childbirth in health institutions is a complex process that involves many patients (mother-child binomial) and multiple interventions, making this an event difficult to evaluate and monitor. It is known that the problem of high maternal and neonatal morbidity and mortality to be intrinsically related to the quality of care and, to address this problem, the World Health Organization (WHO) has developed the Safe Childbirth Checklist (SCC), which has been adapted and validated for the Brazilian context and is named the “Lista de Verificação para o Parto Seguro – Brasil” (LVPS-BR). Implementation of this checklist is a complex process, but the evidence demonstrates its potential effect on improving good practices and patient safety, and studies are needed to evaluate the effectiveness of this tool on the quality of childbirth care. Objectives: (1) to evaluate and compare adherence to Good Practice (GP) and incidence of Obstetric Adverse Events (AE) in maternity hospitals in Brazil and Mexico; (2) develop a platform for monitoring childbirth care indicators; (3) to analyze the effect of LVPS-BR intervention on the quality of obstetric and perinatal care. Method: This is a multicenter research carried out in hospitals in Brazil and Mexico, members of the WHO Safe Childbirth Checklist Collaboration initiative. The design of the Brazilian study was a quasi-experimental mixed study, including time series analysis and before-after analysis, with retrospective data collection in medical records between 2015 and 2016. Comparison of GP and AE indicators between countries and institutions was performed with chi-square tests and illustrated in error bar graphs, and estimates of longitudinal variation, entered in statistical control graphs. Partial results: Regarding objective 1, hospitals in Mexico had higher adherence to GP (58.7%) and lower incidence of AE (12.9%) than Brazilian institutions (26.8% of GP and 16.0% of AE) and, in both countries, hospitals caring at women at low risk had higher AE rates (29.6% in Mexico and 27.2% in Brazil) and lower adherence to GP (51.5% in Mexico and 24 , 5% in Brazil) than general maternity wards. Regarding objective 2, the tool for monitoring the quality of childbirth, called Plataforma QualiParto, is in the development phase of its beta version (AE module). It will allow the automatic collection and analysis of childbirth indicators from reports containing descriptive tables and graphs (bars, histograms and run charts) for cross-sectional and longitudinal monitoring of estimates. The study of the effect of the intervention with the LVPS is in the process of processing, analysis and interpretation of the data. Perspectives: The main results of this study (GP and AE profile characterization, development of technology for monitoring childbirth quality and intervention with checklist) help health professionals and services to identify and intervene on problems in childbirth quality, benefiting both clinical care for mothers and their children as well as financial and organizational management of obstetric services.

BANKING MEMBERS:
Presidente - 1868020 - ZENEWTON ANDRÉ DA SILVA GAMA
Interno - 277398 - KENIO COSTA DE LIMA
Externa à Instituição - LENICE GNOCCHI DA COSTA REIS - ENSP