Poor adherence to neonatal resuscitation guidelines exposed; an observational study using camera surveillance at a tertiary hospital in Nepal

Autor: Caroline Lindbäck, Ashish Kc, Ravi Vitrakoti, Johan Wrammert, Mats Målqvist, Uwe Ewald
Jazyk: angličtina
Rok vydání: 2014
Předmět:
Male
Suction (medicine)
medicine.medical_specialty
Resuscitation
Cross-sectional study
medicine.medical_treatment
Video Recording
Suction
Reliability of results
Developing countries
Tertiary Care Centers
Nepal
medicine
Humans
Caesarean section
Pediatrics
Perinatology
and Child Health
Intensive care medicine
Neonatal mortality
Asphyxia Neonatorum
business.industry
Crying
Process Assessment
Health Care
Infant
Newborn
Infant
Public Health
Global Health
Social Medicine and Epidemiology
Newborn
Respiration
Artificial
Low birth weight
Folkhälsovetenskap
global hälsa
socialmedicin och epidemiologi
Cross-Sectional Studies
Practice Guidelines as Topic
Pediatrics
Perinatology and Child Health
Emergency medicine
Female
Observational study
Guideline Adherence
medicine.symptom
business
Noninvasive ventilation
Neonatal resuscitation
Research Article
Zdroj: BMC Pediatrics
ISSN: 1471-2431
Popis: Background Each year an estimated 10 million newborns require assistance to initiate breathing, and about 900 000 die due to intrapartum-related complications. Further research is required in several areas concerning neonatal resuscitation, particularly in settings with limited resources where the highest proportion of intrapartum-related deaths occur. The aim of this study is to use CCD-camera recordings to evaluate resuscitation routines at a tertiary hospital in Nepal. Methods CCD-cameras recorded the resuscitations taking place and CCD-observational record forms were completed for each case. The resuscitation routines were then assessed and compared with existing guidelines. To evaluate the reliability of the observational form, 50 films were randomly selected and two independent observers completed two sets of forms for each case. The results were then cross-compared. Results During the study period 1827 newborns were taken to the resuscitation table, and more than half of them (53.3%) were noted as not crying prior to resuscitation. Suction was used in almost 90% of newborns brought to the resuscitation table, whereas bag-and-mask ventilation was only used in less than 10%. The chance to receive ventilation with bag-and-mask for a newborn not crying when brought to the resuscitation table was higher for boys (AdjOR 1.44), low birth weight babies (AdjOR 1.68) and babies that were delivered by caesarean section (AdjOR 1.64). The reliability of the observational form varied considerably amongst the different variables analyzed, but was high for all variables concerning the use of bag-and-mask ventilation and the variable whether suction was used or not, all matching in over 91% of the forms. Conclusions CCD camera technique was a feasible method to assess resuscitation practices in this low resource hospital setting. In most aspects, the staff did not adhere to guidelines regarding neonatal resuscitation. The use of bag-and-mask ventilation was inadequate, and suction was given excessively in terms of protocol. Further studies exploring the underlying causes behind the lack of adherence to the neonatal resuscitation guidelines should be conducted. Electronic supplementary material The online version of this article (doi:10.1186/1471-2431-14-233) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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