Melhoria da qualidade da assistência à mulher em uma maternidade pública pela implantação do Maternal Early Warning Score (MEWS)

Abstract

INTRODUCTION: The quality of the maternal health service can be measured by the technical-scientific dimension, defined by professional competence and the use of good evidence. The Maternal Early Warning Score (MEWS) is an instrument based on changes in vital signs that allows detecting the clinical worsening of the hospitalized patient, intervening early and decreasing maternal morbidity. OBJECTIVE: To implement MEWS as a tool to improve health care for women in a referral service. OBJECTIVE: To implement MEWS as a tool to improve health care for women in a referral service. METHOD: It is an almost experimental study, non-controlled and before-after type, ruled in improve quality principles. Happened in Maternidade Escola Januário Cicco (MEJC), linked to Universidade Federal do Rio Grande do Norte (UFRN) and managed by statal Empresa Brasileira de Serviços Hospitalares (EBSERH). The target population was composed of 455 professionals and women admitted to the maternity unit during the period studied. The implementation of MEWS took place in five stages, covering presentation, flowchart creation, software development, training and monitoring of vital signs. Retrospective data collection performed on 6,969 electronic medical records, from September / 2019 to August / 2020. Data analysis was descriptive and inferential, with the calculation of absolute and relative improvements, using the “z” test, considering the p-value <0.05, to verify significance. RESULTS: The “PANEL MEWS” software bringed benefits to data compilation and may possible an improvement cycle for vital sign gauging, provided significant improvement with the training of 30.7% of professionals and showing a relative improvement of 35% in the measurement of respiratory rate, 45% in heart rate, 20% in temperature and 34% in the measurement of all vital signs. CONCLUSION: The participation of TI was fundamental in the creation of the panel for the compilation of data, enabling the application of the improvement cycle throughout MEJC in the gauging of vital signs. The COVID - 19 pandemic caused many withdrawals and suspension of educational activities, jeopardizing the continuity of these effective interventions. The implementation process showed itself very challenger to need participation of many actors, of equipments for view of panel by professionals and effective implementation of MEWS to enable decreased severe morbidity in the MEJC.