Quantifying nursing care delivered in Kenyan newborn units: protocol for a cross-sectional direct observational study.
Quantifying nursing care delivered in Kenyan newborn units: protocol for a cross-sectional direct observational study.
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DOI：
10.1136/bmjopen-2018-022020
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发表时间：
2018-07-23
期刊：
影响因子：
2.9
通讯作者：
English M
中科院分区：
文献类型：
--
作者：
Gathara D;Serem G;Murphy GAV;Abuya N;Kuria R;Tallam E;English M
在包括肯尼亚在内的许多非洲国家，实现儿童生存目标的一个主要障碍是新生儿死亡率下降缓慢，目前新生儿死亡率占5岁以下儿童死亡率的45%。在新生儿护理中，护士是新生儿环境中的主要照顾者，在提供安全有效的护理方面至关重要。然而，由于患者工作量大和资源有限，护士可能经常有意识或无意识地优先考虑他们提供的护理，导致一些任务未完成或部分完成（错过护理）。在高收入国家，错过护理与患者预后不良有关。然而，通过直接观察检查的遗漏护理以前没有成为低/中等收入国家的研究主题。本研究的目的是量化的新生儿护理提供给新生儿单位内的新生儿。我们将在内罗毕市郡的六个卫生设施的新生儿单位内进行一项横断面研究，采用直接观察方法，涉及公共、私营营利性和私营非营利部门。在2017年9月1日至2018年5月30日期间，将对总共216名新生儿进行观察。分层随机抽样将用于选择随机的12小时观察期，而目的抽样将用于确定新生儿进行直接观察。我们将报告未完成的护理的总体流行率，未完成的常见任务，并描述与没有正式资格提供护理的人分担的任何任务。本研究的伦理批准已由肯尼亚医学研究所科学和伦理审查部门授予。将征求母亲和护士的书面知情同意书。这项工作的结果将与参与医院分享，这是一个由参与决策的成员组成的专家咨询小组，并通过会议和同行评审期刊更广泛地与国际社会分享。
In many African countries, including Kenya, a major barrier to achieving child survival goals is the slow decline in neonatal mortality that now represents 45% of the under-5 mortality. In newborn care, nurses are the primary caregivers in newborn settings and are essential in the delivery of safe and effective care. However, due to high patient workloads and limited resources, nurses may often consciously or unconsciously prioritise the care they provide resulting in some tasks being left undone or partially done (missed care). Missed care has been associated with poor patient outcomes in high-income countries. However, missed care, examined by direct observation, has not previously been the subject of research in low/middle-income countries. The aim of this study is to quantify essential neonatal nursing care provided to newborns within newborn units. We will undertake a cross-sectional study using direct observational methods within newborn units in six health facilities in Nairobi City County across the public, private-for-profit and private-not-for-profit sectors. A total of 216 newborns will be observed between 1 September 2017 and 30 May 2018. Stratified random sampling will be used to select random 12-hour observation periods while purposive sampling will be used to identify newborns for direct observation. We will report the overall prevalence of care left undone, the common tasks that are left undone and describe any sharing of tasks with people not formally qualified to provide care. Ethical approval for this study has been granted by the Kenya Medical Research Institute Scientific and Ethics Review Unit. Written informed consent will be sought from mothers and nurses. Findings from this work will be shared with the participating hospitals, an expert advisory group that comprises members involved in policy-making and more widely to the international community through conferences and peer-reviewed journals.
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