Transferência de cuidados da equipe de enfermagem obstétrica para equipe médica na assistência ao parto e ao nascimento: protocolo assistencial do Hospital de Clínicas Da Universidade Federal De Uberlândia

Abstract

Introduction: Obstetric care for women at usual risk can be performed by both the medical team and obstetric nursing and, although it usually occurs within normal limits, it can present unfavorable outcomes. Obstetric nursing already represents the largest provider of care for pregnant women in various parts of the world. Despite the benefits of this care model, care protocols that guide the transfer of care during the practice of these professionals have not yet been found in the literature. Objective: To build an assistance protocol for the transfer of care from the obstetric nursing team to the medical team in childbirth and birth care, to guide professionals working in maternal and neonatal health, at the Hospital de Clinicas, Universidade Federal de Uberlândia. Methodology: Bibliographic research with the main guidelines related to assistance to labor and birth, published in Portuguese or English between 2014 and 2020. Results: The main indications for transfer may be related to maternal, fetal conditions, failure in the progress of labor or obstetric emergencies. Maternal conditions that indicate the need to transfer care are related to changes in maternal vital signs (tachycardia, pressure increase, hyperthermia), detection of proteinuria under examination, vaginal bleeding before and after delivery, unusual abdominal pain and / or stress of labor analgesia. In relation to fetal conditions, the transfer of care should be performed when changes in fetal presentation are identified, suspicion or diagnosis of changes in fetal size, suspicion or diagnosis of changes in amniotic fluid, significant meconium and / or changes in fetal heart rate. The transfer of care related to the progress of labor is indicated when a failure in the progress of the first or second period of labor is detected. And, in relation to obstetric emergencies, the transfer of care must be carried out through the presence of changes in the mother's general physical condition, prolonged duration of the third period with inadequate blood loss and uterine contraction, adverse events with 3rd or 4th degree lacerations and / or complicated perineal injuries. The obstetrical nurse must offer detailed verbal information to the woman and her companion, request assistance from the obstetrician and ensure continuity of care, within their technical and scientific knowledge, until the transfer is made. Conclusion: The transfer of care refers to the delegation of responsibility for the assistance to be provided during the evolution of labor and / or birth. It is indicated due to the development of abnormalities and / or complications in the evolution of labor and / or birth, which require a more complex level of attention. The professional of theobstetric nursing team is responsible for identifying the occurrence of deviations from normality during their care, in order to carry out an immediate diagnosis and management.