Cargando…
Nursing knowledge of essential maternal and newborn care in a high‐mortality urban African setting: A cross‐sectional study
AIMS: To assess the knowledge of nurses of national guidelines for emergency maternity, routine newborn and small and sick newborn care in Nairobi County, Kenya. BACKGROUND: The vast majority of women deliver in a health facility in Nairobi. Yet, maternal and neonatal mortality remain high. Ensuring...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6472564/ https://www.ncbi.nlm.nih.gov/pubmed/30357971 http://dx.doi.org/10.1111/jocn.14695 |
_version_ | 1783412265045721088 |
---|---|
author | Murphy, Georgina A. V. Gathara, David Mwaniki, Ann Nabea, Grace Mwachiro, Jacintah Abuya, Nancy English, Mike |
author_facet | Murphy, Georgina A. V. Gathara, David Mwaniki, Ann Nabea, Grace Mwachiro, Jacintah Abuya, Nancy English, Mike |
author_sort | Murphy, Georgina A. V. |
collection | PubMed |
description | AIMS: To assess the knowledge of nurses of national guidelines for emergency maternity, routine newborn and small and sick newborn care in Nairobi County, Kenya. BACKGROUND: The vast majority of women deliver in a health facility in Nairobi. Yet, maternal and neonatal mortality remain high. Ensuring competency of health workers, in providing essential maternal and newborn interventions in health facilities will be key if further progress is to be made in reducing maternal and neonatal mortality in low‐resource settings. DESIGN: Cross‐sectional survey. METHODS: Questionnaires comprised of clinical vignettes and direct questions and were administered in 2015–2016 to nurses (n = 125 in 31 facilities) on duty in maternity and newborn units in public and private facilities providing 24/7 inpatient neonatal services. Composite knowledge scores were calculated and presented as weighted means. Associations were explored using regression. STROBE guidelines were followed. RESULTS: Nurses scored best for knowledge on active management of the mother after birth and immediate routine newborn care. Performance was worst for questions on infant resuscitation, checking signs and symptoms of sick newborns, and managing hypertension in pregnancy. Overall knowledge of care for sick newborns was particularly low (score 0.62 of 1). Across all areas assessed, nurses who had received training since qualifying performed better than those who had not. Poorly resourced and low case‐load facilities had lower average knowledge scores compared with better‐resourced and busier facilities. CONCLUSION: Overall, we estimate that 31% of maternity patients, 3% of newborns and 39% of small and sick newborns are being cared for in an environment where nursing knowledge is very low (score <0.6). RELEVANCE TO CLINICAL PRACTICE: Focus on periodic training, ensuring retention of knowledge and skills among health workers in low‐case load setting, and bridging the know‐do gap may help to improve the quality of care delivered to mothers and newborns in Kenya. |
format | Online Article Text |
id | pubmed-6472564 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-64725642019-04-19 Nursing knowledge of essential maternal and newborn care in a high‐mortality urban African setting: A cross‐sectional study Murphy, Georgina A. V. Gathara, David Mwaniki, Ann Nabea, Grace Mwachiro, Jacintah Abuya, Nancy English, Mike J Clin Nurs Original Articles AIMS: To assess the knowledge of nurses of national guidelines for emergency maternity, routine newborn and small and sick newborn care in Nairobi County, Kenya. BACKGROUND: The vast majority of women deliver in a health facility in Nairobi. Yet, maternal and neonatal mortality remain high. Ensuring competency of health workers, in providing essential maternal and newborn interventions in health facilities will be key if further progress is to be made in reducing maternal and neonatal mortality in low‐resource settings. DESIGN: Cross‐sectional survey. METHODS: Questionnaires comprised of clinical vignettes and direct questions and were administered in 2015–2016 to nurses (n = 125 in 31 facilities) on duty in maternity and newborn units in public and private facilities providing 24/7 inpatient neonatal services. Composite knowledge scores were calculated and presented as weighted means. Associations were explored using regression. STROBE guidelines were followed. RESULTS: Nurses scored best for knowledge on active management of the mother after birth and immediate routine newborn care. Performance was worst for questions on infant resuscitation, checking signs and symptoms of sick newborns, and managing hypertension in pregnancy. Overall knowledge of care for sick newborns was particularly low (score 0.62 of 1). Across all areas assessed, nurses who had received training since qualifying performed better than those who had not. Poorly resourced and low case‐load facilities had lower average knowledge scores compared with better‐resourced and busier facilities. CONCLUSION: Overall, we estimate that 31% of maternity patients, 3% of newborns and 39% of small and sick newborns are being cared for in an environment where nursing knowledge is very low (score <0.6). RELEVANCE TO CLINICAL PRACTICE: Focus on periodic training, ensuring retention of knowledge and skills among health workers in low‐case load setting, and bridging the know‐do gap may help to improve the quality of care delivered to mothers and newborns in Kenya. John Wiley and Sons Inc. 2018-11-26 2019-03 /pmc/articles/PMC6472564/ /pubmed/30357971 http://dx.doi.org/10.1111/jocn.14695 Text en © 2018 The Authors Journal of Clinical Nursing Published by John Wiley & Sons Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Murphy, Georgina A. V. Gathara, David Mwaniki, Ann Nabea, Grace Mwachiro, Jacintah Abuya, Nancy English, Mike Nursing knowledge of essential maternal and newborn care in a high‐mortality urban African setting: A cross‐sectional study |
title | Nursing knowledge of essential maternal and newborn care in a high‐mortality urban African setting: A cross‐sectional study |
title_full | Nursing knowledge of essential maternal and newborn care in a high‐mortality urban African setting: A cross‐sectional study |
title_fullStr | Nursing knowledge of essential maternal and newborn care in a high‐mortality urban African setting: A cross‐sectional study |
title_full_unstemmed | Nursing knowledge of essential maternal and newborn care in a high‐mortality urban African setting: A cross‐sectional study |
title_short | Nursing knowledge of essential maternal and newborn care in a high‐mortality urban African setting: A cross‐sectional study |
title_sort | nursing knowledge of essential maternal and newborn care in a high‐mortality urban african setting: a cross‐sectional study |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6472564/ https://www.ncbi.nlm.nih.gov/pubmed/30357971 http://dx.doi.org/10.1111/jocn.14695 |
work_keys_str_mv | AT murphygeorginaav nursingknowledgeofessentialmaternalandnewborncareinahighmortalityurbanafricansettingacrosssectionalstudy AT gatharadavid nursingknowledgeofessentialmaternalandnewborncareinahighmortalityurbanafricansettingacrosssectionalstudy AT mwanikiann nursingknowledgeofessentialmaternalandnewborncareinahighmortalityurbanafricansettingacrosssectionalstudy AT nabeagrace nursingknowledgeofessentialmaternalandnewborncareinahighmortalityurbanafricansettingacrosssectionalstudy AT mwachirojacintah nursingknowledgeofessentialmaternalandnewborncareinahighmortalityurbanafricansettingacrosssectionalstudy AT abuyanancy nursingknowledgeofessentialmaternalandnewborncareinahighmortalityurbanafricansettingacrosssectionalstudy AT englishmike nursingknowledgeofessentialmaternalandnewborncareinahighmortalityurbanafricansettingacrosssectionalstudy |