Avaliação do conhecimento, atitude e prática dos profissionais de enfermagem sobre hemorragia pós-parto

Abstract

Every day, around 800 women die from complications during pregnancy and childbirth around the world. High rates of maternal deaths occur in resource-poor developing countries, and most of these maternal deaths could have been prevented. In the world, one in five maternal deaths are due to hemorrhage. The objective of the study was to evaluate the knowledge, attitude and practice of nursing professionals in identifying and managing postpartum hemorrhage. This was an intervention study, with a quasi-experimental pre- and post-test design. The study site was the maternity ward of a medium-complexity hospital, a reference in maternal and child care, located in a city in the interior of the state of Pernambuco. Study participants were nurses and nursing technicians who work in the Reception with Risk Classification in Obstetrics, roomingin and delivery sectors of the respective maternity. Data collection took place from July to November 2022, after approval by the Research Ethics Committee. 43 nursing professionals participated in the study, 22 nurses and 21 nursing technicians. Nursing professionals, in general, demonstrated ignorance of some important precautions during the care of a patient with PPH, such as: starting intravenous tranexamic acid (1g) as soon as the hemorrhage is identified; maintenance dose of oxytocin, intravenous, after responsiveness to the attack dose and use of the shock index to identify patients who will have a higher risk of hypovolemia as a result of obstetric causes. The attitudes of both nurses and nursing technicians were unsatisfactory, particularly with regard to the low level of communication between professionals and patients, family members and the team itself. In practices, nurses, although they received a regular classification, some conducts were no longer performed, such as: inspection of the skin and mucous membranes and emptying of the patient's bladder. In the practice of technicians, regarding the identification of a patient with PPH, the evaluation of uterine contractility was the one that appeared in lesser evidence. In-service training in the care of postpartum women with postpartum hemorrhage allows health professionals to provide timely and more qualified care, with a view to patient safety and the reduction of maternal mortality.