Efficacy of a Discharge Checklist for Neonates in Reducing Neonatalmorbidity and Mortality
Abstract
Of the estimated 5.9 million child deaths in 2015, almost 1 million occurred
in the first day of life while about 2 million deaths occurred in the first week. Most of these
deaths are readily preventable or treatable with proven, cost-effective interventions. The
checklist can act as a tool to reduce neonatal morbidity and mortality.
Objective: The primary objective was to determine the impact of introducing a
standardized neonatal discharge checklist on the rate of hospitalization during the neonatal
period at the Kenyatta National Hospital. The secondary objective was to determine the
acceptability of a structured postnatal discharge checklist among health care workers at
Kenyatta National Hospital.
Study design setting and population: a mixed method study that included the Quasi
experimental pre- post intervention design and focus group discussion was carried out in
the post- natal wards at Kenyatta National Hospital, which is the main referral hospital.
Neonates with no complications awaiting discharge were enrolled for the study after
consent was obtained.
Methodology: Qualitative and quantitative methods were incorporated in this study.
Structured questionnaires were administered to both the mothers in the postnatal ward and
the trained nurses on the checklist for the danger signs of newborns, breastfeeding,
immunization and the use of chlorhexidine in cleaning the umbilical stump. Qualitative
data was obtained using focus group discussions.
Results: Hospitalization rates were 7.4% and 3.2 % in the pre intervention and post
intervention periods respectively. There was significant improvement in knowledge on
cord cleaning after the intervention (p =<0.001) as well as on identifying newborn danger
signs (p=0.005). There was a trend noted for reduced hospitalization following introduction
of the neonatal discharge checklist.
Conclusion: There was a trend for reduced hospitalization following implementation of
the neonatal discharge checklist. Acceptability of the discharge checklist was appreciated
by health care workers while a call for collaboration with the paediatric department was
emphasized.
Publisher
University of Nairobi
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
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