Continuity of care as central theme in perinatal care: A systematic review

Abstract

Problem

The global shortage of nurses is straining perinatal care, disrupting continuity of care and negatively affecting patient outcomes.

Background

Continuity of care is essential in perinatal care, where the complexity of maternal and infant needs requires coordinated care across the antenatal, intrapartum, and postpartum periods.

Aim

To provide an overview of the current literature on continuity of care in the interprofessional perinatal care from the perspective of nursing.

Methods

Guided by the Joanna Briggs Institute, a search in seven academic databases was conducted in March 2023. A thematic synthesis was carried out to structure and integrate the findings.

Findings

A total of 23 articles were identified. Studies explored the impact of continuity of care, served as determinant or outcome, categorised into relational, management, and informational continuity. Notably, continuity as a determinant was the most commonly investigated aspect. Five determinants were identified related to three outcome categories: patient-reported experience measures, patient-reported outcomes, and the prevention or reduction of complications.

Discussion

Continuity of care is mainly manifested in relational and management continuity, with known healthcare professionals, whether or not involved in a care program, being key determinants. The most positive outcomes related to continuity of care were found in the patient-reported experience measures.

Conclusion

The personal relationship between patient, parents and healthcare professionals is crucial. Informational continuity is underrepresented in perinatal care research, and there is a lack of research on the relationship between continuity of care and patient-reported outcomes.