Improving Nursing Care for Children Admitted in High Dependency Area in Acute Care Unit Mulago Hospital, Uganda
Repository Posting Date2018-05-29T19:06:58Z
Author DetailsMary Grace Akao, Bsc N, Dip Midw; Elizabeth Ayebare, PhDc, MSN, BSN; Scovia Mbalinda, RN, BSN, MSc, PRH
Lead Author Sigma AffliationNon-member
Level of EvidenceQualitative Study, Other
Background/context: Acute Care Unit is an emergency unit for children which admits 800 children monthly. The patients are initiated on treatment, stabilized and later transfer to the specialized wards. According to unit data for 2015, the rate of death was high at 4.6% mainly within 24 hours of admission. Very sick children are admitted in the High Dependency Area (HDA) for close monitoring. Majority of the children died in the HDA where close monitoring and care is expected. This prompted the development of this quality improvement project.
Aim: To improve nursing care rendered to children in High Dependency Area so as to facilitate recovery and reduce mortality.
Measures: Baseline survey was conducted to identify common diseases and the causes of death of children admitted in High Dependency Area. A check list was used to review records of 83 children admitted in HDA during a two weeks period in December 2016.
Results: The median age of children was 18 (0- 156) months. Most of the admissions (76.6%) occurred during the day. Mothers constituted 87.2% of the care takers. Medical conditions of children admitted were; severe pneumonia 34.2%, severe malaria 13.9%, and sickle cell disease 11.4%. The percentage of deaths in unit in December 2016 was 6.9% and majority aggravated by hypoglycemia and aspiration pneumonia. None of the case files had nursing care plan however, doctors’ orders were present.
Interventions: Nurses allocated to HDA in all 3 shifts daily. All children in HDA monitored for hypoglycemia. Care takers were taught and facilitated on how to effectively feed their children to prevent aspiration pneumonia and hypoglycemia. The end line data collection is still ongoing.
Conclusion: Care takers involvement and proper nursing care can reduce death in critically ill children in a low resource setting.
Funder(s)Johnson & Johnson
DescriptionThis poster is the summation of a project undertaken as part of the Honor Society of Nursing, Sigma Theta Tau International, Maternal-Child Health Nurse Leadership Academy (2016-2017 cohort).
Conference NameChi Xi at-Large Chapter First Biennial Conference Swaziland
Conference HostChi Xi at-Large Chapter
Conference LocationRoyal Swazi Convention Center, Exulwini Valley, Lobamba, Swaziland
Date of Publication2018-05-29
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