Avaliação da atenção ao recém-nascido de risco no município de Maringá-PR

Abstract

Introduction: Evaluating the process of assistance to risk newborns allows to identify service performance and highlights the quality of care, once this is one of the conditions to ensure care the effectiveness offered to risk newborns. Objective: To evaluate the assistance provided to the newborn at risk monitoring Program (PVRNR) of the municipality of Maringá-PR in its process component and result in the year of 2007. Methodology: This is a cross-sectional descriptive analytical study, quantitative approach and is entered in the evaluation of health services, with a random sample of 505 children at risk distributed in 25 Basic Health Units in Maringá-PR, Brazil the Information System on Live Births (SINASC), the Monitoring Sheet, archives and interviews with mothers. Diagnostic tests performed to validate the inclusion criteria and for the association analysis were considered as the dependent variables the appropriate outcome, eutrophic and ≥ 5 medical consultations and inappropriate outcome, does not eutrofic to 12 months of age and maternal, neonatal and care variables as independent variables. Results: The PVRNR considered only biological risks related to mother and newborn as a criterion for inclusion, and can the same be isolated at (63.2%) or associated among themselves (36.8%), should prevail with maternal age 18 years (36%) and low weight at birth (28.8%). Concerning mothers, 71.5% were adults, 78.2% had good schooling, 57.2% without companion, 55.3% had a no paid occupation, 69.5% had an enough number of prenatal, 87.3% with an only pregnancy, and childbirth caesarean took 65,4%. Regarding risk newborns, 51% were male, 50.3% were with birth under weight, 51.5% term, 95,8% without congenital anomalies and 90.3% with Apgar score ≥ 7 in 5th minute. On assistance to children of risk 69.5% were accompanied by PVRNR, 71% of patient records were found in basic health units, 82,6% with no home visit, 8,9% received ≥ 12 medical consultations, 33,1% have not received any guidance, 5.8% were hospitalized, 18.7% presented ≥ 12 weight, 19.8% presented full full immunization record. Discharge assigned by PVRNR to the accompanied group meant the end of the follow-up of the child up to 12 months of age. Diagnostic tests showed a low sensitivity PVRNR detect individuals at risk and to evaluate the outcomes of children after discharge from the PVRNR resulted in 92 (36.8%) children as "appropriate outcome" and 158 (63.2%) as "inappropriate outcome". Bivariate analysis revealed statistically significant association for the variables maternal age, weight, gestational age at birth, associated inclusion criteria, nursing and medical care given, antropometrics measures guidelines and immunization record. In multivariate analysis confirmed the variables that influence for inappropriate child outcome were the weight at birth, medical care and the number of given guidelines weights. Although mothers confirmed shortcomings in assistive process showed good level of satisfaction with regard to the reception and the medical and nursing care (76.4% and 89.7% respectively). Conclusion: Assistance to risk newborn focused on offering medical consultations without access by risk prioritization with deficiencies in assistive process. A competent diagnosis of children's health profile of risk to 12 months of age at the time of termination of their follow-up by PVRNR, allows you to plan and implement health actions and achieve good results especially when refers to biopsychosocial growth and development of children.