Analysis of obstetrical data registered in the Patient health Record

Authors

  • Shirley Lima Silva Universidade de Santo Amaro
  • Isaac Rosa Marques Universidade de Santo Amaro

DOI:

https://doi.org/10.5380/ce.v12i2.6937

Keywords:

Parto normal, Enfermagem obstétrica, Registros de enfermagem, Natural childbirth, Obstetrical nursing, Nursing records, Enfermería obstétrica, Registros de enfermería.

Abstract

This study aimed at analysing registered information in the Patient Health Record and to identify the profile of first time pregnant women related to demographic, admission physical examination, and obstetrical data. It is a descriptive-exploratory study about Patient Health Record registries of first time pregnant women who had normal childbirth in a referral hospital in the city of São Paulo. One hundred and twelve health records constituted the sample. Of the data under analysis, obstetrical data had major incidence of irregular registries, being the variables specular examination, amniotic sac integrity, presentation of the sac, and data of the pelvic basin the most unregistered data. It was concluded that the fact of not registering these data can be a negative factor in the decision making process during normal childbirth.

Author Biographies

Shirley Lima Silva, Universidade de Santo Amaro

Aluna do 4o. ano da Faculdade de Enfermagem da Universidade de Santo Amaro, São Paulo, SP.

Isaac Rosa Marques, Universidade de Santo Amaro

Mestre em Enfermagem pela UNIFESP. Professor Adjunto da Faculdade de Enfermagem da Universidade de Santo Amaro.

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Published

2007-11-26

How to Cite

Silva, S. L., & Marques, I. R. (2007). Analysis of obstetrical data registered in the Patient health Record. Cogitare Enfermagem, 12(2). https://doi.org/10.5380/ce.v12i2.6937

Issue

Vol. 12 No. 2 (2007)

Section

Research

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