Universidade de Brasília. Faculdade de Ciências da Saúde. Departamento de Saúde Coletiva. Brasília/DF, Brasil.
Ministério da Saúde. Secretaria de Vigilância. Brasília/DF, Brasil.
Rev Saude Publica. 2020 Feb 10;54:23. doi: 10.11606/s1518-8787.2020054001497. eCollection 2020.
To describe some characteristics of the 97 teaching hospitals participating in the Projeto de Aprimoramento e Inovação no Cuidado e Ensino em Obstetrícia e Neonatologia (Apice ON-Project for Improvement and Innovation in Care and Teaching in Obstetrics and Neonatology).
The semester prior to the beginning of the program was adopted as the baseline to evaluate the subsequent structural and processes changes of this project. Secondary data from the first half of 2017 were extracted from the National Registry of Health Establishments (NRHE), the Hospital Information System and the Sistema de Informações sobre Nascidos Vivos (SINASC-Live Birth Information System).
Before the implementation of the project, only 66% of the hospitals had a Baby-friendly Hospital Initiative, only 3% offered special accommodations for high-risk pregnant women, mothers and their newborns, and 45.4% hospitals adopted the skin-to-skin contact; 97% hospitals had separate rooms for pre-labor and vaginal delivery (93%), not following the recommendations of the Ministry of Health; nine hospitals (9%) had no rooming-in; there were few obstetrics nurses (less than 1% of professionals enrolled in the NRHE), and in only six hospitals the proportion of births assisted by this professional was above 50% of vaginal deliveries, while in eight this percentage ranged between 15% and 50%; the average cesarean section rate was 42%, ranging between 37.6% (Southeast) and 49.1% (Northeast); ten hospitals did not charge for companions according to inpatient hospital authorization.
The study strengthens the relevance of the Apice ON project as an inducer of change of the care model in teaching hospitals and, therefore, as a strategy for the implementation of the national public policy represented by the Stork Network.
描述参与 Projeto de Aprimoramento e Inovação no Cuidado e Ensino em Obstetrícia e Neonatologia（Apice ON-Project for Improvement and Innovation in Care and Teaching in Obstetrics and Neonatology）的 97 家教学医院的一些特征。
该方案在实施前的一个学期被选为基线，以评估该项目随后的结构和过程变化。2017 年上半年的次要数据从国家卫生机构登记处（NRHE）、医院信息系统和 Sistema de Informações sobre Nascidos Vivos（SINASC-活产信息系统）中提取。
在项目实施之前，只有 66%的医院实施了爱婴医院倡议，只有 3%的医院为高危孕妇、母亲及其新生儿提供特殊住宿，45.4%的医院采取了皮肤接触；97%的医院为产前和阴道分娩提供了单独的房间（93%），不符合卫生部的建议；9 家医院（9%）没有母婴同室；妇产科护士很少（不到 NRHE 注册专业人员的 1%），只有 6 家医院由该专业人员协助的分娩比例高于阴道分娩的 50%，而 8 家医院的这一比例在 15%至 50%之间；剖宫产率平均为 42%，范围在 37.6%（东南部）至 49.1%（东北部）之间；有 10 家医院根据住院医院授权不向陪伴者收费。
该研究强调了 Apice ON 项目的相关性，作为教学医院护理模式变革的推动者，因此也是代表鹳网络的国家公共政策的实施策略。
