Expectations for nursing care in newborn units in Kenya: moving from implicit to explicit standards
Expectations for nursing care in newborn units in Kenya: moving from implicit to explicit standards
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DOI：
10.1136/bmjgh-2017-000645
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发表时间：
2018-03-01
影响因子：
8.1
通讯作者：
English, Mike
中科院分区：
文献类型：
--
作者：
Murphy, Georgina A. V.;Omondi, Gregory B.;English, Mike
目前，新生儿死亡率占肯尼亚所有儿童死亡率的45%，为每1000例活产死亡22例。为小新生儿和患病新生儿提供基本但高质量的新生儿住院服务将是降低新生儿死亡率的关键。新生儿住院护理依赖于护理，但肯尼亚目前没有明确的护理标准。我们审查了肯尼亚护理委员会的“临床程序手册”，以确定住院新生儿护理相关的任务。一个由主要利益攸关方、决策者、培训人员和一线卫生工作者组成的专家咨询小组应邀参加了一个讲习班，其目的是确定护士负责的任务以及向肯尼亚医院住院新生儿交付这些任务的最低标准。尽管在开始的过程中存在意见分歧，但就新生儿护理的最低标准达成了共识。关键结果是新生儿护理任务的综合列表和分组以及这些任务应执行的最低频率。其次，根据护理需求对新生儿患者进行简单分类。此外，商定并描述了与其他干部和患者家属分担新生儿护理任务的可接受形式。该过程被发现是可接受的政策制定者和从业者，谁认识到在新生儿护理标准的价值，以提高新生儿住院护理的质量。这些标准可以成为审计和质量评价的基础。
Neonatal mortality currently accounts for 45% of all child mortality in Kenya, standing at 22 per 1000 live births. Access to basic but high quality inpatient neonatal services for small and sick newborns will be key in reducing neonatal mortality. Neonatal inpatient care is reliant on nursing care, yet explicit nursing standards for such care do not currently exist in Kenya. We reviewed the Nursing Council of Kenya 'Manual of Clinical Procedures' to identify tasks relevant for the care of inpatient neonates. An expert advisory group comprising major stakeholders, policy-makers, trainers, and frontline health-workers was invited to a workshop with the purpose of defining tasks for which nurses are responsible and the minimum standard with which these tasks should be delivered to inpatient neonates in Kenyan hospitals. Despite differences in opinions at the beginning of the process, consensus was reached on the minimum standards of neonatal nursing. The key outcome was a comprehensive list and grouping of neonatal nursing task and the minimum frequency with which these tasks should be performed. Second, a simple categorisation of neonatal patients based on care needs was agreed. In addition, acceptable forms of task sharing with other cadres and the patient's family for the neonatal nursing tasks were agreed and described. The process was found to be acceptable to policy-makers and practitioners, who recognised the value of standards in neonatal nursing to improve the quality of neonatal inpatient care. Such standards could form the basis for audit and quality evaluation.