scholarly journals The Effect of a Decision-Support mHealth Application on Maternal and Neonatal Outcomes in Two District Hospitals in Rwanda: Quasi-Experimental Study

2020 ◽  
Author(s):  
Aurore Nishimwe ◽  
Latifat Ibisomi ◽  
Marc Nyssen ◽  
Daphney Nozizwe Conco
Keyword(s):  
Decision Support ◽  
Post Partum ◽  
Neonatal Resuscitation ◽  
Newborn Care ◽  
Neonatal Outcomes ◽  
P Value ◽  
Post Intervention ◽  
District Hospitals ◽  
Quasi Experimental ◽  
Maternal And Neonatal Outcomes

Abstract Background: Globally, mobile health (mHealth) applications are known for their potential to improve healthcare providers’ access to relevant and reliable health information. Besides, electronic decision support tools, such as the Safe Delivery mHealth Application (SDA), help to reduce clinical errors and to ensure quality care at the point of service delivery. The current study assessed the effects of the SDA on basic emergency obstetric and newborn care (BEmONC) outcomes for the most frequent complications in Rwanda; post-partum haemorrhage (PPH) and newborn asphyxia and its complications.Methods: The study adopted a quasi-experimental design. A pre-intervention record review of the BEmONC outcomes: Apgar score and PPH progressions, was conducted. The intervention took place in two district hospitals in Rwanda and entails the implementation of the SDA for six months. Six months’ post-intervention, the effect of the SDA on BEmONC outcomes was evaluated. The study included 327 participants (114 cases of PPH and 213 cases of neonatal complications). The analysis compared the outcome variables between the baseline and the endline data. Fisher’s exact test was used to compare the proportions and test between-group differences and significance level set at p<0.05. Results: Unstable newborn outcome following neonatal resuscitation was recorded in 61.90% and 27.59% newborns cases at baseline and endline respectively, P-value = 0.000. Unstable maternal outcome following PPH management was recorded in 19.40 % and 6.38% maternal cases at baseline and endline respectively, P-value = 0.048. There was a significant association between the SDA intervention and newborns’ and maternal’ outcomes following neonatal resuscitation and PPH management, 6 months after baseline.Conclusion: The use of the SDA supported nurses and midwives in the management of PPH and neonatal resuscitation thus improved maternal and neonatal outcomes after 6 months of the SDA intervention.

scholarly journals The Effect of a Decision-Support mHealth Application on Maternal and Neonatal Outcomes in Two District Hospitals in Rwanda: Quasi-Experimental Study

2020 ◽  
Author(s):  
Aurore NISHIMWE ◽  
Latifat IBISOMI ◽  
Marc NYSSEN ◽  
Daphney NOZIZWE CONCO
Keyword(s):  
Decision Support ◽  
Post Partum ◽  
Neonatal Resuscitation ◽  
Newborn Care ◽  
Neonatal Outcomes ◽  
P Value ◽  
Post Intervention ◽  
District Hospitals ◽  
Quasi Experimental ◽  
Maternal And Neonatal Outcomes

Abstract Background: Globally, mobile health (mHealth) applications are known for their potential to improve healthcare providers’ access to relevant and reliable health information. Besides, electronic decision support tools, such as the Safe Delivery mHealth Application (SDA), help to reduce clinical errors and to ensure quality care at the point of service delivery. The current study assessed the effects of the SDA on basic emergency obstetric and newborn care (BEmONC) outcomes for the most frequent complications in Rwanda; post-partum haemorrhage (PPH) and newborn asphyxia and its complications.Methods: The study adopted a quasi-experimental design. A pre-intervention record review of the BEmONC outcomes: Apgar score and PPH progressions, was conducted. The intervention took place in two district hospitals in Rwanda and entails the implementation of the SDA for six months. Six months’ post-intervention, the effect of the SDA on BEmONC outcomes was evaluated. The study included 327 participants (114 cases of PPH and 213 cases of neonatal complications). The analysis compared the outcome variables between the baseline and the endline data. Fisher’s exact test was used to compare the proportions and test between-group differences and significance level set at p<0.05. Results: Unstable newborn outcome following neonatal resuscitation was recorded in 61.90% and 27.59% newborns cases at baseline and endline respectively, P-value = 0.000. Unstable maternal outcome following PPH management was recorded in 19.40 % and 6.38% maternal cases at baseline and endline respectively, P-value = 0.048. There was a significant association between the SDA intervention and newborns’ and maternal’ outcomes following neonatal resuscitation and PPH management, 6 months after baseline.Conclusion: The use of the SDA supported nurses and midwives in the management of PPH and neonatal resuscitation thus improved maternal and neonatal outcomes after 6 months of the SDA intervention.

scholarly journals Family-centered postnatal training and adherence to newborn care practices in district hospitals in two Indian states: A quasi-experimental intervention study

2021 ◽  
Author(s):  
Sehj Kashyap ◽  
Amanda F Spielman ◽  
Nikhil Ramnarayan ◽  
Sahana SD ◽  
Rashmi Pant ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Intervention Study ◽  
Intervention Group ◽  
Newborn Care ◽  
Post Intervention ◽  
Indian States ◽  
District Hospitals ◽  
Quasi Experimental ◽  
Care Practices ◽  
Family Centered

Background and Objectives: Globally, 2.5 million newborns die within the first month of life annually. The majority of deaths occur in low- and middle-income countries (LMICs), and many of these deaths happen at home. The study assessed if the Care Companion Program (CCP) an in-hospital, skills-based training given to families improves post-discharge maternal and neonatal health outcomes. Methods: This quasi-experimental pre-post intervention study design compared self-reported behavior and health outcomes among families before and after the CCP intervention. Intention to treat analysis included families regardless of their exposure to the intervention. Mixed effects logistic regression model, adjusted for confounders, was fit for all observations. Effects were expressed as Relative Risks (RR) with 95% Confidence Intervals (CI). Results: At 2-weeks post-delivery, telephone surveys were conducted in the pre (n = 3510) and post-intervention (n = 1474) groups from 11 district hospitals in the states of Karnataka and Punjab. The practice of dry cord care improved significantly by 4%, (RR = 1.04, 95%CI [1.04,1.06]) and skin to skin care by 78% (RR=1.78, 95%CI [1.37,2.27]) in the post-intervention group as compared to pre-intervention group. Furthermore, newborn complications reduced by 16% (RR=0.84, 95%CI [0.76,0.91]), mother complications by 12% (RR=0.88, 95%CI [0.79,0.97]) and newborn readmissions by 56% (RR=0.44, 95%CI [0.31,0.61]). Outpatient visits increased by 27% (RR=1.27, 95%CI [1.10,1.46]). However, outcomes of breastfeeding, mothers diet, hand-hygiene, and process indicator of being instructed on warning signs were not different. Conclusion: Postnatal care should incorporate pre-discharge multi-pronged training of families to improve essential maternal and newborn care practices. The CCP model runs on a public-private partnership and is integrated into existing health systems. Our findings demonstrate that it is possible to improve outcomes through a family-centered approach in India. The CCP model can be integrated into formalised hospital processes to relieve overburdened healthcare systems in LMIC settings.

scholarly journals Quality of the documentation of the Nursing process in clinical decision support systems

2021 ◽  
Vol 29 ◽  
Author(s):  
Neurilene Batista de Oliveira ◽  
Heloísa Helena Ciqueto Peres
Keyword(s):  
Decision Support ◽  
Clinical Decision Support ◽  
Clinical Decision Support Systems ◽  
Clinical Decision ◽  
P Value ◽  
Nursing Process ◽  
Post Intervention ◽  
Quasi Experimental ◽  
Process Documentation

Objective: to compare the quality of the Nursing process documentation in two versions of a clinical decision support system. Method: a quantitative and quasi-experimental study of the before-and-after type. The instrument used to measure the quality of the records was the Brazilian version of the Quality of Diagnoses, Interventions and Outcomes, which has four domains and a maximum score of 58 points. A total of 81 records were evaluated in version I (pre-intervention), as well as 58 records in version II (post-intervention), and the scores obtained in the two applications were compared. The interventions consisted of planning, pilot implementation of version II of the system, training and monitoring of users. The data were analyzed in the R software, using descriptive and inferential statistics. Results: the mean obtained at the pre-intervention moment was 38.24 and, after the intervention, 46.35 points. There was evidence of statistical difference between the means of the pre- and post-intervention groups, since the p-value was below 0.001 in the four domains evaluated. Conclusion: the quality of the documentation of the Nursing process in version II of the system was superior to version I. The efficacy of the system and the effectiveness of the interventions were verified. This study can contribute to the quality of documentation, care management, visibility of nursing actions and patient safety.

scholarly journals Effect of Abdominal Physiotherapy in Reduction of Inter Recti Distance in Postpartum Females

2021 ◽  
Vol 15 (6) ◽  
pp. 1446-1448
Author(s):  
K. Kazmi ◽  
G. M. Hashmi ◽  
M. Bilal ◽  
N. Iqbal ◽  
Wajeeha . ◽  
...  
Keyword(s):  
Post Partum ◽  
Tertiary Care ◽  
Abdominal Muscle ◽  
Postnatal Period ◽  
P Value ◽  
Care Hospital ◽  
Post Intervention ◽  
Gynecology And Obstetrics ◽  
Diastasis Recti ◽  
Quasi Experimental

Aim: To see the effect of abdominal exercises in the recovery of diastasis recti in post natal females. Methodology: A Quasi Experimental study design was used to enroll 40 participants from OPD of Gynecology and Obstetrics from a Tertiary Care Hospital Lahore between ages ranged from 18 to 30 years. Using purposive sampling all postpartum females having diastasis of rectus abdominis muscles with inter recti distance more than 2 fingers width were enrolled. All the study participants received abdominal muscle exercises program for 30 min a day in 8 week program. inter recti distance was measured by using two finger palpation method. All the pre intervention and post intervention data were recorded into a short structured proforma.Results were considered significant for p value ≤ 0.05. Results: 40 participants were selected in this study with an age from 18- 30 years. The inter recti distance was significantly reduced as p value was ≤ 0.05 for both (above umbilicus and below umbilicus) groups. Conclusion: It was observed that abdominal exercises helped in the recovery of diastasis and reduced the separation between the muscles in postpartum women. It also enlightens the importance of the prescription of physiotherapy in reduction of post partum complications. Keywords: Abdominal Exercises, Diastasis Recti, Pregnancy, Postnatal period,

scholarly journals Clinical Stratification of Pregnant COVID-19 Patients based on Severity: A Single Academic Center Experience

2021 ◽  
Vol 38 (05) ◽  
pp. 515-522
Author(s):  
Marissa Berry ◽  
Amanda Wang ◽  
Shannon M. Clark ◽  
Hassan M. Harirah ◽  
Sangeeta Jain ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Disease Severity ◽  
Gestational Age ◽  
Laboratory Data ◽  
Population Characteristics ◽  
Neonatal Outcomes ◽  
P Value ◽  
Asymptomatic Patients ◽  
Increased Risk ◽  
Maternal And Neonatal Outcomes

Objective This study aimed to describe baseline characteristics of a cohort of pregnant women infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and determine if these correlate with disease severity and perinatal outcomes. Study Design This was a retrospective cohort trial conducted at the University of Texas Medical Branch Galveston, Texas. All pregnant women presented to our medical center, who were screened and tested positive for SARS-CoV-2 virus, were included. We stratified our study population in three groups: asymptomatic, symptomatic not requiring oxygen therapy, and patients requiring oxygen support to maintain oxygen saturation >94%. Relevant population characteristics, laboratory data, and maternal and neonatal outcomes were abstracted. A p-value <0.05 was considered statistically significant. Results Between March and July 2020, 91 women tested positive for SARS-CoV-2 upon admission to our labor and delivery unit. Among these, 61.5% were asymptomatic, 34.1% were symptomatic, and 4.4% required oxygen support. Our population was mainly Hispanic (80.2%), multiparous (76.9%), obese (70.3%), and with a median age of 27 years. Median gestational age at symptom onset or diagnosis was 36 weeks. Significant differences were found between gestational age and disease severity. Maternal characteristics including age, body mass index (BMI), and presence of comorbid conditions did not appear to influence severity of SARS-CoV-2 infection. Significant laboratory findings associated with increasing disease severity included decreasing hemoglobin and white blood cell count, lymphopenia, and increasing levels of inflammatory markers including CRP, ferritin, and procalcitonin. Maternal and neonatal outcomes did not differ among groups. No SARS-CoV-2 was detected by polymerase chain reaction testing in neonates of mothers with COVID-19. Conclusion Pregnant patients with COVID-19 infection are predominantly asymptomatic. Patients appear to be at increased risk for more severe infection requiring oxygen support later in pregnancy. Key Points

scholarly journals OBSTETRIC OUTCOMES

2011 ◽  
Vol 18 (01) ◽  
pp. 11-17
Author(s):  
FOUZIA YASMEEN ◽  
NABEELA SHAMI ◽  
WASEEM TALIB
Keyword(s):  
Live Birth ◽  
Low Birthweight ◽  
Placental Abruption ◽  
Neonatal Outcomes ◽  
Instrumental Delivery ◽  
Labour Induction ◽  
Obstetric Outcomes ◽  
P Value ◽  
Cohort Group ◽  
Maternal And Neonatal Outcomes

Objectives: To compare obstetric outcomes in the pregnancy subsequent to still birth with that following live birth in first pregnancy. Data Source: Medline data base. Study Design: Prospective cohort study. Setting: Ghurki Trust Teaching Hospital Lahore. Materials & Methods: The study included women who delivered a stillbirth between 2005 - 2007(exposed cohort). A group of women with live birth (unexposed cohort) was matched for delivery within the same year, maternal age (+/- 3 years), parity (+/- 1). In 2009, the charts of these women were examined for subsequent pregnancies. Main outcome measures Maternal and neonatal outcomes in the second pregnancy, pre eclampsia, placental abruption, labour induction, instrumental delivery, caesarean delivery, malpresentation, prematurity, low birthweight and stillbirth. Results: The exposed cohort group B (n =50) was at increased risk of preeclampsia (44% versus 28%, p value = 0.001<0.05) and placental abruption (20% versus 2%) and malpresentation (18% versus 4%). labour induction (20% versus 8%) instrumental delivery (16%versus 8%) and emergency caesarean (40%versus 16%); and prematurity (62%versus 26%, p value = 0.001<0.05), low birthweight (86% versus 54%, p value = 0.000<0.05) and stillbirths (6% versus 2%, p value = 0.489>0.05) of the infant as compared with the unexposed cohort group A (n =50). Conclusions: Majority of women with a previous stillbirth have a live birth in the subsequent pregnancy, they are a highrisk group with an increased incidence of adverse maternal and neonatal outcomes.

scholarly journals The Effectiveness of the Use of Nurse Safety Booklet on Nurse Knowledge in Ergonomic Injury Prevention in BIMA Hospital

2019 ◽  
Vol 4 (2) ◽  
pp. 108
Author(s):  
A. Haris ◽  
Abdul Haris
Keyword(s):  
Health Services ◽  
Intervention Group ◽  
Hospital Staff ◽  
Control Group ◽  
P Value ◽  
Research Subjects ◽  
Post Intervention ◽  
Quasi Experimental ◽  
The Difference ◽  
Nurse Knowledge

Safety has become a global issue in various sectors, including the health services sector. The hospital is one of the health service organizations that is guided to continuously improve quality by building safer and safer health services so as to get customer loyalty. Hospital staff is a major component of quality management in one of the indicators in evaluating hospital accreditation. This research uses a quasi-experimental research design pre and posttest with control group. Quasi experiment research is a study that tests an intervention in a group of research subjects and then measures the results of the intervention. Samples in this study are all nurses who are in the room of the General Hospital, Surgery and ICU Bima Hospital, which are 50 people. The results showed the results of different tests using paired t-test p value = 0.000 which can be concluded that there are differences between the intervention group and the control group, seen from the value of the difference in the intervention group is greater than the difference in the control group can be interpreted as education using more booklets affect the increase in nurse knowledge. The conclusion in this study was that there were significant differences in nurses' knowledge after being given education using pre and post intervention booklets between the intervention and control groups (p = 0.000).

scholarly journals PEMBERIAN SALEP KUNYIT DAPAT MENGURANGI STRIAE GRAVIDARUM PADA IBU NIFAS

2021 ◽  
Vol 7 (2) ◽  
pp. 279-286
Author(s):  
Syahroni Damanik ◽  
Rauda Rauda
Keyword(s):  
Post Partum ◽  
Sampling Technique ◽  
Wilcoxon Test ◽  
Bivariate Analysis ◽  
P Value ◽  
Self Confidence ◽  
Post Test ◽  
Quasi Experimental ◽  
Postpartum Mothers ◽  
Striae Gravidarum

GIVING Turmeric Ointment MAY REDUCE STRIAE GRAVIDARUM IN THE PUPERATIVE MOTHER Background:Striaegravidarum is a sign or stretch that occurs on the skin of 50% to 90% of women during the second half of pregnancy. Nearly half of women experience stretching of the skin, especially in the abdomen, as a result of increasing gestational age.The presence of striae gravidarum causes a lack of self-confidence in the post-partum mother, so this makes the postpartum mother have to undergo medication and even surgery to restore her skin to the state before she was pregnant.The purpose: of this study was to determine the effect of turmeric ointment in reducing Striaegravidarum in postpartum mothers at the Hj. DewiSesmeraS.Tr.Keb Aluminum IV TanjungMulia Medan in 2020.Methods: This study used a Quasy Experiment Design (Quasi-Experimental Design) using a One Group Pretest-Postest Design. The population and sample in this study were all postpartum mothers with 15 people. This study used Porposive sampling technique with univariate and bivariate analysis with T Test.Results: the research obtained from data analysis with the Wilcoxon test showed that post-partum mothers could conclude pre-test and post-test giving turmeric ointment. The results in the table show that the P-Value (0.001) <α 0.05 then Ho is rejected and Ha is accepted, which means that there is an effect of pre-test and post-test on the administration of turmeric ointment in reducing striaegravidarum.Conclusion: This study shows that there is an effect of turmeric ointment in reducing striaegravidarum. Suggestions for the clinic mother Hj. Dewi Sesmera so that mothers can advise postpartum mothers to make their own products with ingredients derived from traditional turmeric in reducing striaegravivarum. Keywords: Key words: Turmeric ointment, Striae gravidarum, postpartum mother

scholarly journals PENGARUH PEMBERIAN BUAH NAGA TERHADAP KADAR HEMOGLOBIN PADA IBU HAMIL TRIMESTER III DI KLINIK BIDAN SRI WAHYUNI KECAMATAN UJUNG PADANG KABUPATEN SIMALUNGUN TAHUN 2020

2021 ◽  
Vol 3 (2) ◽  
pp. 188-201
Author(s):  
Desideria Yosepha Ginting ◽  
Layari Tarigan ◽  
Susi Endriyana
Keyword(s):  
Sample Selection ◽  
The Body ◽  
Rank Test ◽  
P Value ◽  
Post Intervention ◽  
Wilcoxon Sign Rank Test ◽  
Dragon Fruit ◽  
Quasi Experimental ◽  
Wilcoxon Sign Rank ◽  
Sign Rank Test

ABSTRACT Anaemia or often referred to as lack of blood is a condition in which the number of red blood cells decreases and results in insufficient oxygen-carrying capacity to meet the body's physiological needs. Problems that arise include an increase in heart rate due to the body trying to provide more oxygen to the tissues, an increase in respiratory rate as the body tries to provide more oxygen to the blood, dizziness due to lack of blood to the brain, feeling tired due to increased oxygenation of various organs including the heart muscle. and skeletal, pale skin due to reduced oxygenation, nausea due to decreased gastrointestinal blood flow and central nervous system, decreased hair and skin quality. Overcoming complaints of anaemia non-pharmacological can be done with dragon fruit. The purpose of this study was to determine the effectiveness of dragon fruit in dealing with complaints of anaemia in the Sri Wahyuni ​​clinic, Ujung Padang sub-district, Simalungun district in 2020. This study used a quantitative method, with a quasi-experimental design with a control time-series design. The population of this study were pregnant women who experienced symptoms of anaemia at the Sri Wahyuni ​​Clinic, Ujung Padang District, Simalungun Regency. The sample selection using purposive sampling of 14 people, 7 people were given intervention and 7 people as controls. The results of the study using the Wilcoxon sign rank test showed that the results for the group given pre and post-intervention p-value 0.026 <0.05. The results of the study using the Wilcoxon sign rank test showed that the control p-value was 0.000 <0.05. The conclusion is that there are differences in the two groups after being given dragon fruit in overcoming complaints of anaemia.

scholarly journals Effectiveness of periurethral cleaning solution to bacteria colonization count at periurethral area prior to urinary catheterization.

2016 ◽  
Vol 1 (1) ◽  
pp. 66
Author(s):  
Kristina Lisum ◽  
Ni Luh Widani
Keyword(s):  
Patient Safety ◽  
Normal Saline ◽  
Povidone Iodine ◽  
Control Group ◽  
P Value ◽  
Regression Result ◽  
Post Intervention ◽  
Cleaning Solution ◽  
Quasi Experimental ◽  
Reducing Bacteria

<div align='justify> Introduction :Patient safety is an important element that must be notice when providing care to patients, including nurse. The incidence of catheterized patient increasingly 25 % from total patients that hospitalized can lead urinary tract infection.  The purpose of this study was to compare the effectiveness of cleaning periurethral with povidone iodine 10 %, povidone iodine 2 % and normal saline to bacteria colonization prior to catetherization. Methods : This study used quasi-experimental, pre and post intervention design with control group.  Result : Periurethral swabs were obtained from a total 60 patients ( povidone iodine 10 % as control group , 20;  povidone iodine 2 %, 20; normal saline, 20).  Through paired t-test ,there  was significant decreased  (p value : .00; p < .05) in bacteria colonization count  using povidone iodine 2% and normal saline ; using  povidone iodine  10 %  , there was no significant decreased (p value : .55; p >.05) in bacteria colonization count. While, a simple linear regression result that povidone iodine 2% is the most effective solution on reducing bacteria colonization in periurethral area rather than other solution. In addition, recommendation needed to test bacteria colonization in urine culture using those periuretral cleaning solutions. Keyword: periurethral cleaning, patient safety, povidone iodine 2%, povidone iodine 10%, normal saline

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