Abstract

Introduction. The postnatal period is a critical phase in the lives of mothers and newborn babies. Most maternal and infant deaths occur within the first 24 hours following birth, but this is the most neglected period for the provision of quality care. Postnatal care starts immediately after birth in the labor ward and continued in the next 6 hours as prescribed by the World Health Organization. Midwives are responsible for the management of low risk postnatal wards where low risk postnatal mothers (+ 1150-1250 per month) are admitted at a referral hospital in Uganda, . Even if they are low risk, all mothers need proper observation of vital signs and notation of any warning signs of potential problems. Audits of postnatal records in 2018 indicated few vital and warning signs being recorded in the charts of low risk postpartum mothers and neonates showing inadequate monitoring before discharge. It further revealed that 60% to 77% of recently discharged neonates, were admissions to the acute care unit for health related problems that presented at home.

Aim: To strengthen assessment of vital and warning signs of low risk mothers in the postnatal care period in order to identify early obstetrical and neonatal emergent problem, and to prevent admission of neonates from low risk mothers shortly after discharge.

Methodology: The project entailed the following:

  • The top management were sensitized regarding the identified problem of postnatal care for resource mobilization.
  • Midwives, doctors and students were trained on assessment of vital and warning sign of postnatal mothers.
  • Standard operation procedures were developed on postnatal assessment.
  • Inter-professional approach was adopted for implementation in strategic places.

Results: The top management supported the project and allocated four champion midwives to mentor other health workers in assessment of vital and warning signs. Fifty health workers were trained and posters have been developed as Standard Operating Procedures (SOPs) for placement in strategic places. With audits it is found that most of the mother and neonatal vital signs and warning signs are assessed according to the SOPs.

Conclusion: An inter-professional approach is needed to enhance continuous quality improvement of postnatal care.

Implication: The project implied buy-in from management and the inter-professional team to initiate policy changes and a focus on education, monitoring and evaluation to reduce maternal and neonatal morbidity and mortality.

Author Details

Lovisa Naisu, RM/RN, BSN; Ms. Beatrice Amuge, PGDM HSM, MPH, BSCN, PHN, URN, URN; DR Scovia N. Mbalinda, PhD, MSc Fell Med, Ed RM/N

Sigma Membership

Non-member

Lead Author Affiliation

Mulago National Referral Hospital, Kampala, Uganda

Type

Poster

Format Type

Text-based Document

Study Design/Type

Quality Improvement

Research Approach

Translational Research/Evidence-based Practice

Keywords:

Maternal-child Health, Postnatal Assessment, Inter-professional Quality Improvement Initiative

Conference Name

Inter-professional Education and Collaborative Practice for Africa Conference

Conference Host

Tau Lambda at-Large Chapter of Sigma Theta Tau International||Amref International University||WHO-FIC Collaborating Centre for the African region||Africa Interprofessional Education Network (AfrIPEN)||WHO Regional Office for Africa

Conference Location

Nairobi, Kenya

Conference Year

2019

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

Additional Files

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Twenty-four hour observation of vital and warning signs in low-risk postpartum care

Nairobi, Kenya

Introduction. The postnatal period is a critical phase in the lives of mothers and newborn babies. Most maternal and infant deaths occur within the first 24 hours following birth, but this is the most neglected period for the provision of quality care. Postnatal care starts immediately after birth in the labor ward and continued in the next 6 hours as prescribed by the World Health Organization. Midwives are responsible for the management of low risk postnatal wards where low risk postnatal mothers (+ 1150-1250 per month) are admitted at a referral hospital in Uganda, . Even if they are low risk, all mothers need proper observation of vital signs and notation of any warning signs of potential problems. Audits of postnatal records in 2018 indicated few vital and warning signs being recorded in the charts of low risk postpartum mothers and neonates showing inadequate monitoring before discharge. It further revealed that 60% to 77% of recently discharged neonates, were admissions to the acute care unit for health related problems that presented at home.

Aim: To strengthen assessment of vital and warning signs of low risk mothers in the postnatal care period in order to identify early obstetrical and neonatal emergent problem, and to prevent admission of neonates from low risk mothers shortly after discharge.

Methodology: The project entailed the following:

  • The top management were sensitized regarding the identified problem of postnatal care for resource mobilization.
  • Midwives, doctors and students were trained on assessment of vital and warning sign of postnatal mothers.
  • Standard operation procedures were developed on postnatal assessment.
  • Inter-professional approach was adopted for implementation in strategic places.

Results: The top management supported the project and allocated four champion midwives to mentor other health workers in assessment of vital and warning signs. Fifty health workers were trained and posters have been developed as Standard Operating Procedures (SOPs) for placement in strategic places. With audits it is found that most of the mother and neonatal vital signs and warning signs are assessed according to the SOPs.

Conclusion: An inter-professional approach is needed to enhance continuous quality improvement of postnatal care.

Implication: The project implied buy-in from management and the inter-professional team to initiate policy changes and a focus on education, monitoring and evaluation to reduce maternal and neonatal morbidity and mortality.