Abstract

Background/context: Umbilical cord infection poses significant risks for neonatal morbidity and mortality in developing countries. In agreement with the World Health Organization (WHO) recommendation, the Ugandan Ministry of Health recommends dry umbilical cord care. The project is being implemented at an acute care unit at a National Referral Hospital. The unit offers emergency care, mostly to children being referred from other health units. Admitted children spend an average of 24 hours on the unit before being transferred to other units for continued care. On average the unit admits 140 neonates (0-3 weeks of age) monthly, of which 56 (40%) are admitted with sepsis due to cord infection. The up-take of the recommendation for dry umbilical care has been very slow, as mothers and caretakers of children admitted to the acute care unit lack appropriate cord care knowledge and practices, resulted in this project.

Aim: To improve cord care management of neonates in an Acute Care Unit

Target: Nurses working at ACU and mothers with neonates aged 0-3 weeks.

Method/ Intervention: Training materials for dry cord care were identified and provided. Nurses have been oriented and trained to offer support to mothers for dry cord care: proper hand washing, use of normal saline to clean the cord with a swab from the base to the top of the cord until the cord is clean and to be left dry. In addition, nurses identify and dispel myths regarding application of substances to the cord.

Results: Standard operating procedures for cord care have been developed. Eleven out of 15 nurses working at the acute care unit have been trained to offer support to mothers for dry cord care practice. Cord care support is now integrated into usual nursing care. Twenty five percent of mothers with neonates aged less than three weeks have been trained to offer cord care to their neonates.

Conclusion: The implementation of dry cord care at an acute care setting is feasible. The scale up of dry cord care in other units should consider dispelling myths regarding application of substances to the cord.

Implications: The project implied policy changes, as well as education of staff, to create changes in practice to reduce neonatal morbidity and mortality related to cord sepsis.

Author Details

Margaret Berocan Adokorach, Mulago Hospital, Kampala, Uganda; Tom Denis Ngabirano, Department of Nursing, College of Health Sciences, Makerere University; Scovia Nalugo Mbalinda, Department of Nursing, College of Health Sciences, Makerere University

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, Neonatal Cord Care, Neonatal Acute Care Unit

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

download (34 kB)

Share

COinS
 

Improving cord care of neonates in an acute care unit at a Ugandan referral hospital

Nairobi, Kenya

Background/context: Umbilical cord infection poses significant risks for neonatal morbidity and mortality in developing countries. In agreement with the World Health Organization (WHO) recommendation, the Ugandan Ministry of Health recommends dry umbilical cord care. The project is being implemented at an acute care unit at a National Referral Hospital. The unit offers emergency care, mostly to children being referred from other health units. Admitted children spend an average of 24 hours on the unit before being transferred to other units for continued care. On average the unit admits 140 neonates (0-3 weeks of age) monthly, of which 56 (40%) are admitted with sepsis due to cord infection. The up-take of the recommendation for dry umbilical care has been very slow, as mothers and caretakers of children admitted to the acute care unit lack appropriate cord care knowledge and practices, resulted in this project.

Aim: To improve cord care management of neonates in an Acute Care Unit

Target: Nurses working at ACU and mothers with neonates aged 0-3 weeks.

Method/ Intervention: Training materials for dry cord care were identified and provided. Nurses have been oriented and trained to offer support to mothers for dry cord care: proper hand washing, use of normal saline to clean the cord with a swab from the base to the top of the cord until the cord is clean and to be left dry. In addition, nurses identify and dispel myths regarding application of substances to the cord.

Results: Standard operating procedures for cord care have been developed. Eleven out of 15 nurses working at the acute care unit have been trained to offer support to mothers for dry cord care practice. Cord care support is now integrated into usual nursing care. Twenty five percent of mothers with neonates aged less than three weeks have been trained to offer cord care to their neonates.

Conclusion: The implementation of dry cord care at an acute care setting is feasible. The scale up of dry cord care in other units should consider dispelling myths regarding application of substances to the cord.

Implications: The project implied policy changes, as well as education of staff, to create changes in practice to reduce neonatal morbidity and mortality related to cord sepsis.