SUMMARY
In a search for new pathways wich may better characterize the educational nursing actions at the Prenatal Care Outpatients Clinic of the University Hospital, Faculty of Medicine of Ribeirão Preto, University of São Paulo, a study consisting of two different stages was carried out. The first phase was based on a retrospective survey on nursing notes made on medical records. The second phase consisted of observation of the guidance provided by the health professionals who assisted women during the prenatal period.
The retrospective study showed the objective and the desire to educate, although in practice this was done in a routine and conditioning manner. The notes on the medical records were poor in quality due to inaccuracy, lack of specificity and absense of meaningful content.
The second phase of the study showed that the guidance and services most often provided by the nursing professional were: VACCINATION (65.3%); INSTRUCTIONS FOR PREGNANT WOMEN (Appendix I), and MEDICAL PRESCRIPTIONS (62.6%), respectively, and scheduling of RETURN VISITS (32.0%). Only one topic, SMOKING DURING PREGNANCY, was not focused by the nursing professionals. It was also noted that the topics were treated in a superficial manner and that the pregnant women rarely paticipated while being instructed. The category that providel most guidance to the pregnant women was the nursing aid, followed by the technical nurse, and finally by the nurse.
To demonstrate the complexity of the functions of the nurse encharge of for the outpatient clinical, a survey was made to identify administrative, assistential, educational, and other activities performed. Of 1057 activities, 52.1% were administrative, 19.1% assistential, 17.8% were classified as others, and 11.0% were educational.
The results lead us to the conclusion that the multiplicity and overlap of functions, together with the enormous responsibilities attributed to the nurse during her professional practice, considerably impair her active participation in providing overall health care to the mother-child binomium.
On the basis of the theoretical foundation of systemin approach, it is suggested that the educational nursing actions by systematized by means of three levels of attention (I, II and III), in an attempt to promote adequate care for women during gestation.
Obstetrical nursing; Prenatal care