Care Practices during Neonatal Period for Preterm Babies in Kisii Teaching and Referral Hospital, Kenya
Abstract
Background: Preterm birth is a global problem with the greatest burden experienced in sub-Saharan Africa and South Asia. In Kenya it is estimated that 12.3/100 live births are born preterm and prematurity is the leading cause of death in the first month of life, contributing to 35% of all neonatal mortality. In high income countries survival rate for preterm babies has increased due to offering care that is evidence based. However, in middle and low income countries the uptake of desired practices is low leading to poor outcomes. The aim of the study was to describe the care practices for preterm babies during the neonatal period in Kisii Teaching and Referral Hospital (KTRH).
Methods: A cross sectional descriptive study was conducted in the newborn unit of KTRH between April and May 2015. Fifty three preterm babies’ parents and fifteen nurses were consented to participate in the study through census sampling method. Data was collected using a checklist. Data was analyzed using descriptive statistics.
Results: Thirty three (62%) preterm babies were born in the facility and 20(38%) were referred from other facilities. Only 11(20.8%) mothers of the 53 babies received antenatal steroids. Majority 41(78.8%) of the babies were resuscitated; 40(96.7%) were suctioned and 34(82.9%) received oxygen. The babies were kept warm soon after birth using radiant warmer 49(92.5%), skin-to-skin 3(5.6%) and 1(1.9%) was covered with a blanket and a cap. All preterm babies were treated with antibiotics prophylactically on admission and those who had RDS were put on CPAP. Majority 33(62.3%) of the preterm babies were nursed under the radiant warmer, while 20(37.7%) were nursed in the incubator and in 24(45.3%) kangaroo mother care was offered. Preterm babies were fed through the nasogastric tube initially and gradually fed by cup as the weight increased to 1.7kg and finally breast fed as the weight approached 2.0kg. Twenty seven (50.9%) preterm babies were discharged based on weight gain 20(74.1%), ability to breast feed 27(100%), no morbidities 10(37.0%) and ability to control breathing 16(59.3%).
Recommendations: The facility is using evidence based practices though not adequately. This study recommends appropriate use of evidence based practice during care of preterm babies in order to have good preterm outcomes.
Key words: Care practices, Neonatal period, preterm
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