CHARACTERIZATION OF THE CLINICAL URGENCY CARE VISITS IN A HABITUAL RISK MATERNITY HOSPITAL: A CROSS-SECTIONAL STUDY

Trigueiro, Tatiane Herreira; Vicari, Kauane; Janiacki, Karoline da Luz; Rosa, Ana Paula da; Kissula, Fernanda Karine

doi:10.5380/ce.v27i0.87082

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ORIGINAL ARTICLE • Cogitare Enferm. 27 • 2022 • https://doi.org/10.5380/ce.v27i0.87082 copy

CHARACTERIZATION OF THE CLINICAL URGENCY CARE VISITS IN A HABITUAL RISK MATERNITY HOSPITAL: A CROSS-SECTIONAL STUDY

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to characterize the emergency care services offered in a habitual risk maternity hospital.

Method:

a quantitative, cross-sectional and retrospective research study, with analysis of the indicators corresponding to the emergency care services of a maternity hospital from a capital city in southern Brazil, from January 2018 to December 2019. The data were subjected to descriptive analysis.

Results:

of the 25,451 care visits, 24,307 corresponded to pregnant women, 944 were puerperal women, 119 had undergone miscarriages, 46 are not pregnant, and 35 cases were undefined. The mean number of visits per month was 1,060; with greater demand in the afternoon shift, in the age group between 20 and 29 years old, with a minimum of eight and a maximum of 61 years old; with third trimester of pregnancy and green urgency risk rating representing higher demand. The most frequently recorded reason to seek care was abdominal pain.

Conclusion:

the research contributed to understanding in which Health Care Network services communication should be strengthened, improved and maintained.

DESCRIPTORS:
Women’s Health; Obstetric Nursing; Nursing Care Standards; Pregnant Women; Welcoming

Variables	2018		2019
Variables	N	%	n	%
Visits	12,633	100	12,818	100
Pregnant women	12,031	95.23	12,276	95.51
Puerperal women	502	3.97	442	3.45
After miscarriage	62	0.49	57	0.44
Not pregnant	27	0.21	19	0.15
Undefined	11	0.09	24	0.19
Age of the patients (years old)	12,633	100	12,818	100
<10	0	0	1	0.01
10 ⊢ 20	1,886	14.93	1,873	14.61
20 ⊢ 30	7,353	58.20	7,341	57.27
30 ⊢ 40	3,093	24.48	3,333	26.00
40 ⊢ 50	301	2.38	265	2.07
50 ⊢ 60	0	0	3	0.02
60 ⊢ 70	0	0	2	0.02
Gestational age	12,633	100	12,818	100
1^st trimester (0 - 13 weeks)	2,672	21.15	2,851	22.24
2^nd trimester (14 - 27 weeks)	2,458	19.46	2,700	21.06
3^rd trimester (28 - 40 weeks)	6,826	54.03	6,635	51.76
≥ 41 weeks	51	0.40	36	0.28
Pregnant women with no GA described	24	0.19	54	0.42
Postpartum	502	3.97	442	3.45
After miscarriage	62	0.49	57	0.44
Not pregnant	27	0.21	19	0.15
Undefined	11	0.09	24	0.19
Obstetric risk classification	12,633	100	12,818	100
Blue	2,121	16.79	1,590	12.40
Green	7,838	62.04	8,298	64.74
Yellow	1,501	11.88	1,889	14.74
Orange	74	0.59	109	0.85
Red	1	0.01	3	0.02
Not classified	1,098	8.69	929	7.25

Variables		2018		2019
Variables		N	%	n	%
1^st trimester		2,672	100	2,851	100
	Blue	409	15.31	348	12.21
	Green	1,749	65.46	1,876	65.80
	Yellow	305	11.41	410	14.38
	Orange	16	0.60	22	0.77
	Red	0	0	1	0.04
	Not classified	193	7.22	194	6.80
2^nd trimester		2,458	100	2,700	100
	Blue	312	12.69	262	9.70
	Green	1,650	67.13	1,865	69.07
	Yellow	287	11.68	368	13.63
	Orange	18	0.73	23	0.85
	Red	1	0.04	0	0
	Not classified	190	7.73	182	6.74
3^rd trimester		6,826	100	6,635	100
	Blue	1,261	18.47	890	13.41
	Green	4,085	59.84	4,229	63.74
	Yellow	806	11.81	969	14.60
	Orange	30	0.44	52	0.78
	Red	0	0	1	0.02
	Not classified	644	9.43	494	7.45
≥ 41 weeks		51	100	36	100
	Blue	20	39.22	6	16.67
	Green	23	45.10	21	58.33
	Yellow	6	11.76	3	8.33
	Orange	0	0	1	2.78
	Not classified	2	3.92	5	13.89
Pregnant women with no GA described		24	100	54	100
	Blue	5	20.83	12	22.22
	Green	14	58.33	29	53.70
	Yellow	2	8.33	10	18.52
	Not classified	3	12.50	3	5.56
Puerperal women		502	100	442	100
	Blue	79	15.74	47	10.63
	Green	273	54.38	232	52.49
	Yellow	89	17.73	118	26.70
	Orange	10	1.99	11	2.49
	Not classified	51	10.16	34	7.69
After miscarriage		62	100	57	100
	Blue	22	35.48	15	26.32
	Green	27	43.55	30	52.63
	Yellow	5	8.06	8	14.04
	Not classified	8	12.90	4	7.02
Undefined		11	100	24	100
	Blue	3	27.27	2	8.33
	Green	4	36.36	12	50.00
	Yellow	0	0	2	8.33
	Not classified	4	36.36	8	33.33
Not belonging to the pregnancy-puerperium period		27	100	19	100

Variables	2018		2019
Variables	N	%	n	%
1st trimester	2,672	100	2,851	100
Vaginal blood loss	840	31.44	755	26.48
Test results	499	18.68	633	22.20
Abdominal pain, back pain, uterine contractions	466	17.44	496	17.40
Others	221	8.27	224	7.86
Referral from primary or secondary care	184	6.89	259	9.08
Headache, dizziness, vertigo, epigastralgia, hypertension	157	5.88	189	6.63
Nausea and vomits	140	5.24	138	4.84
Vaginal fluid loss, secretions	69	2.58	75	2.63
Urinary complaints	72	2.69	61	2.14
Trauma	24	0.90	21	0.74
3rd trimester	6,826	100	6,635	100
Abdominal pain, back pain, uterine contractions	2,796	40.96	2,730	41.15
End of pregnancy follow-up evaluation	1,055	15.46	980	14.77
Referral from primary or secondary care	612	8.97	654	9.86
Others	580	8.50	498	7.51
Test results	487	7.13	550	8.29
Vaginal fluid loss, secretions	498	7.30	488	7.35
Headache, dizziness, vertigo, epigastralgia, hypertension	303	4.44	261	3.93
Vaginal blood loss	172	2.52	129	1.94
Stopped or reduced fetal movements	121	1.77	100	1.51
Reassessment	76	1.11	100	1.51
Nausea and vomits	83	1.22	103	1.55
Trauma	43	0.63	42	0.63
≥ 41 weeks	51	100	36	100
End of pregnancy follow-up evaluation	25	49.02	21	58.33
Others	11	21.57	6	16.67
Abdominal pain, back pain, uterine contractions	9	17.65	7	19.44
Referral from primary or secondary care	6	11.76	2	5.56
Postpartum	502	100	442	100
Postpartum return visit	462	92.03	391	88.46
Referral from primary or secondary care	21	4.18	36	8.14
Evasion	14	2.79	9	2.04
Fever, infection signs	2	0.40	0	0.00
Others	3	0.60	6	1.36
After miscarriage	62	100	57	100
Return visit after miscarriage	55	88.71	45	78.95
Test results	2	3.23	5	8.77
Referral from primary or secondary care	3	4.84	3	5.26
Others	2	3.23	2	3.51
Vaginal blood loss	0	0.00	2	3.51
Pregnant women with no GA described	24	100	54	100
Test results	3	12.50	22	40.74
Vaginal blood loss	9	37.50	10	18.52
Referral from primary or secondary care	5	20.83	13	24.07
Others	5	20.83	6	11.11
Abdominal pain, back pain, uterine contractions	2	8.33	3	5.56
Not belonging to the pregnancy-puerperium period	27	100	19	100
Undefined	11	100	24	100

Variables	2018		2019
Variables	N	%	n	%
Reasons for the referrals from the Health Unit to the Maternity Hospital	986	100	1,148	100
Abdominal pain, back pain, uterine contractions	181	18.36	227	19.77
End of pregnancy follow-up evaluation	174	17.65	194	16.90
Headache, dizziness, vertigo, epigastralgia, hypertension	77	7.81	88	7.67
Miscarriage, possible miscarriage	62	6.29	84	7.32
Vaginal blood loss	73	7.40	84	7.32
Fever, infection signs	32	3.25	49	4.27
Urinary complaints	41	4.16	46	4.01
Vaginal fluid loss, secretions	40	4.06	40	3.48
Pregnancy complications	30	3.04	36	3.14
Fetal complications	33	3.35	26	2.26
Nausea and vomits	9	0.91	19	1.66
Reassessment	21	2.13	18	1.57
Shortness of breath, respiratory problems	3	0.30	11	0.96
Stopped or reduced fetal movements	19	1.93	11	0.96
Trauma	9	0.91	8	0.70
Postpartum complications	17	1.72	7	0.61
Consultation and test results	19	1.93	7	0.61
Fainting, general malaise	9	0.91	4	0.35
Diabetes	6	0.61	0	0.00
Violence	4	0.41	0	0.00
Complications after miscarriage	2	0.20	1	0.09
Unspecified complaint	89	9.03	79	6.88
Others	36	3.65	109	9.49

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[1] Role of Authors:

Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work - Trigueiro TH, Vicari K, Janiacki K da L; Drafting the work or revising it critically for important intellectual content - Trigueiro TH, Vicari K, Janiacki K da L, Rosa AP da; Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved - Trigueiro TH. All authors approved the final version of the text.