Abstract

Perinatal and infant mortality remains a serious challenge in developing countries including South Africa. Current statistics indicate that there is high perinatal and infant mortality in the selected district hospital in Tshwane. A retrospective audit of patient's files from March 2013 to April 2014 with the aim of reducing perinatal mortality at secondary and Primary Health Care (PHC) level.

Results indicate that the following are contributing factors of perinatal mortality: cultural beliefs, delayed antenatal referrals, delayed intrapartum referral, lack of transport, poor use of partogram. This factor contributes to the following causes of perinatal mortality: Intrauterine deaths (39%), severe Pre-eclampsia (7%), Antepartum haemorrage (15%), Pregnancy induced hypertension (13%), Hypoxia (11%), Prematurity (7%).

Based on the findings, we established a multi-disciplinary team and implemented an in-service training on Essential Steps in Management of Obstetric Emergencies (ESMOE), weekly unit perinatal discussions of mortality cases, and engaged PHC staff in monthly and quarterly prenatal reviews. We also established an open admission area for screening patients.

We recommend that patient records are reviewed before they are sent for filing, conduct quarterly audit of patient's record, all clients to be linked to Community Health Workers before discharge to strengthen the referral system and to ensure continuity of care during the postnatal period. This will enable the community health workers early and to refer the patients to the hospital for further investigation and management before complications arise.

The impact on mothers, the community an on my leadership journey will be highlighted in the poster.

Description

This presentation is the summation of a project undertaken as part of the Honor Society of Nursing, Sigma Theta Tau International, Maternal-Child Health Nurse Leadership Academy (2014-2015 cohort).

Author Details

Caroline Manamela, Bcur; Sharon Ngomane, Mcur; Roinah Ngunyulu, PhD

Sigma Membership

Non-member

Type

Poster

Format Type

Text-based Document

Study Design/Type

Quality Improvement

Research Approach

Translational Research/Evidence-based Practice

Keywords:

Maternal Child Nursing, Perinatal Deaths

Conference Name

Tau Lambda Conference 2015

Conference Host

Tau Lambda at-Large Chapter of Sigma Theta Tau International

Conference Location

Johannesburg, South Africa

Conference Year

2015

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Faculty/Mentor Approved: Sigma Academy Participant Poster

Acquisition

Proxy-submission

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Contributory factors towards perinatal and infant mortality in Jubilee Hospital

Johannesburg, South Africa

Perinatal and infant mortality remains a serious challenge in developing countries including South Africa. Current statistics indicate that there is high perinatal and infant mortality in the selected district hospital in Tshwane. A retrospective audit of patient's files from March 2013 to April 2014 with the aim of reducing perinatal mortality at secondary and Primary Health Care (PHC) level.

Results indicate that the following are contributing factors of perinatal mortality: cultural beliefs, delayed antenatal referrals, delayed intrapartum referral, lack of transport, poor use of partogram. This factor contributes to the following causes of perinatal mortality: Intrauterine deaths (39%), severe Pre-eclampsia (7%), Antepartum haemorrage (15%), Pregnancy induced hypertension (13%), Hypoxia (11%), Prematurity (7%).

Based on the findings, we established a multi-disciplinary team and implemented an in-service training on Essential Steps in Management of Obstetric Emergencies (ESMOE), weekly unit perinatal discussions of mortality cases, and engaged PHC staff in monthly and quarterly prenatal reviews. We also established an open admission area for screening patients.

We recommend that patient records are reviewed before they are sent for filing, conduct quarterly audit of patient's record, all clients to be linked to Community Health Workers before discharge to strengthen the referral system and to ensure continuity of care during the postnatal period. This will enable the community health workers early and to refer the patients to the hospital for further investigation and management before complications arise.

The impact on mothers, the community an on my leadership journey will be highlighted in the poster.