Improving cord care of neonates in an acute care unit at a Ugandan referral hospital
Repository Posting Date2019-09-19T18:57:14Z
Author DetailsMargaret Berocan Adokorach, Mulago Hospital, Kampala, Uganda; Tom Denis Ngabirano, Department of Nursing, College of Health Sciences, Makerere University; Scovia Nalugo Mbalinda, Department of Nursing, College of Health Sciences, Makerere University
Lead Author Sigma AffliationNon-member
Lead Author AffliationMulago Hospital, Kampala, Uganda
Level of EvidenceQuality Improvement
Research ApproachTranslational Research/Evidence-based Practice
Background/context: Umbilical cord infection poses significant risks for neonatal morbidity and mortality in developing countries. In agreement with the World Health Organization (WHO) recommendation, the Ugandan Ministry of Health recommends dry umbilical cord care. The project is being implemented at an acute care unit at a National Referral Hospital. The unit offers emergency care, mostly to children being referred from other health units. Admitted children spend an average of 24 hours on the unit before being transferred to other units for continued care. On average the unit admits 140 neonates (0-3 weeks of age) monthly, of which 56 (40%) are admitted with sepsis due to cord infection. The up-take of the recommendation for dry umbilical care has been very slow, as mothers and caretakers of children admitted to the acute care unit lack appropriate cord care knowledge and practices, resulted in this project.
Aim: To improve cord care management of neonates in an Acute Care Unit
Target: Nurses working at ACU and mothers with neonates aged 0-3 weeks.
Method/ Intervention: Training materials for dry cord care were identified and provided. Nurses have been oriented and trained to offer support to mothers for dry cord care: proper hand washing, use of normal saline to clean the cord with a swab from the base to the top of the cord until the cord is clean and to be left dry. In addition, nurses identify and dispel myths regarding application of substances to the cord.
Results: Standard operating procedures for cord care have been developed. Eleven out of 15 nurses working at the acute care unit have been trained to offer support to mothers for dry cord care practice. Cord care support is now integrated into usual nursing care. Twenty five percent of mothers with neonates aged less than three weeks have been trained to offer cord care to their neonates.
Conclusion: The implementation of dry cord care at an acute care setting is feasible. The scale up of dry cord care in other units should consider dispelling myths regarding application of substances to the cord.
Implications: The project implied policy changes, as well as education of staff, to create changes in practice to reduce neonatal morbidity and mortality related to cord sepsis.
Conference NameInter-professional Education and Collaborative Practice for Africa Conference
Conference HostSigma Theta Tau’s International Tau Lambda at-Large Chapter
Amref International University
WHO-FIC Collaborating Centre for the African region
Africa Interprofessional Education Network (AfrIPEN)
WHO Regional Office for Africa
Conference LocationNairobi, Kenya
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