scholarly journals Early Identification and Prevention of Postnatal Complications among the Postnatal Mothers by Using the ‘Postnatal Care Bundle’

2021 ◽  
pp. 175-181
Author(s):  
Vaishali Taksande ◽  
Deepti S. Shrivastava ◽  
Sr. Tessy Sebastian
Keyword(s):  
Early Identification ◽  
Postnatal Care ◽  
Quality Care ◽  
Postnatal Period ◽  
Staff Nurses ◽  
Care Bundle ◽  
Normal Delivery ◽  
Postnatal Mothers ◽  
Improve Patient ◽  
Experimental Group

Background: Postnatal period initiates immediately after the birth of a baby. The terms puerperium period is commonly used to refer to the first 6 weeks after delivery of baby. A postnatal care bundle used during this period and it will help to significantly improve patient outcomes. Objective: To develop, test and pilot of Postnatal Care Bundle (PNCB) and to assess conventional postnatal care among the postnatal mothers and to evaluate the effectivity of Postnatal Care Bundle (PNCB) for early identification and prevention of postpartum complications among the postnatal mothers and to assess the satisfaction level of staff nurses after implementation of Postnatal Care Bundle and conventional postnatal care for early identification and prevention of postnatal complications among the postnatal mothers. Methodology: The interventional analytical and true experimental research design approach will be used and the sample use for the postnatal mothers including the full term normal delivery, caesarean section will be and the random sampling use and sample size is 185 in each group i.e. control and experimental group. One group will be received conventional postnatal care and other group will be on postnatal care bundle. The outcome includes that postnatal care bundle help to early identification and prevention of postnatal complications among the postnatal mothers. Conclusion: PNCB will be effective in quality care of postnatal period.

scholarly journals Factors influencing women's knowledge at scheduled postnatal visits: a multi-centre study in Kakamega, Kenya

2021 ◽  
Vol 15 (4) ◽  
pp. 1-8
Author(s):  
Charles Kiragu ◽  
Justus SO Osero ◽  
Anthony K Wanyoro
Keyword(s):  
Postnatal Care ◽  
Health Workers ◽  
Neonatal Morbidity ◽  
Cross Sectional Study ◽  
Postnatal Period ◽  
Systematic Sampling ◽  
Cross Sectional ◽  
Multi Centre Study ◽  
Factors Influencing ◽  
Postnatal Mothers

Background/aims Postnatal care is offered to mothers and their babies from birth and across the postnatal period. Visits are spread over the postnatal period, and a minimum of four visits is recommended. In many studies, postnatal visits in Africa have been reported to be low compared to antenatal visits. As a result of low postnatal visits, mothers are not able to utilise postnatal care services, resulting in delayed detection of and interventions for maternal and neonatal health problems, leading to high rates of maternal and neonatal morbidity and mortality. In Kenya, only 53% of mothers attend postnatal clinics; in Kakamega county, only 34% of mothers attend. This study aimed to establish factors influencing postnatal knowledge among mothers in selected hospitals in Kakamega, Kenya. Methods The study was a descriptive cross-sectional study involving 320 postnatal mothers recruited from four sub-counties. Systematic sampling was used to select eligible study participants. Data were collected using questionnaires that assessed the participants' knowledge of postnatal care in terms of what postnatal care is, recommended postnatal care, when to attend a clinic and the services offered at postnatal care clinics. The data were entered into a database and analysed using the Chi-squared test to assess how sociodemographic and socioeconomic characteristics were associated with knowledge of postnatal care. Results The majority of participants (73.1%) had poor or no knowledge of postnatal care and 89.7% had poor or no knowledge on when postnatal visits should be carried out. Most postnatal mothers (71.9%) received postnatal health information from health workers. Occupation (P<0.000), income (P<0.000), transport (P<0.000) and time taken to travel to hospital (P=0.034) were significantly associated with postnatal knowledge. Conclusions Knowledge on postnatal care is poor among postnatal mothers in Kakamega. The majority of participants obtained postnatal care information from health workers, and so it is recommended that Kakamega establishes other strategies for giving information on postnatal care, such as pamphlets to mothers.

scholarly journals A Hospital based Randomized Controlled Trial to Evaluate the Effectiveness of Kegel's Exercise on Postpartum Perineal Laxity

2011 ◽  
Vol 3 (3) ◽  
pp. 157-159
Author(s):  
Sudha A Raddi ◽  
TT Sheeba ◽  
MB Ballad
Keyword(s):  
Vaginal Delivery ◽  
Postnatal Care ◽  
Controlled Trial ◽  
Control Group ◽  
Control Groups ◽  
Randomized Controlled ◽  
Postnatal Mothers ◽  
Perineal Muscle ◽  
And Control ◽  
Experimental Group

ABSTRACT Objectives The objectives of the study are to: (i) Assess the perineal muscle strength of postnatal mothers after vaginal delivery in the experimental and control groups before and after the intervention. (ii) Evaluate the effectiveness of Kegel's exercise on perineal laxity in the experimental group compared to control group. Methods This single blinded randomized controlled trial at a 1000 bedded tertiary care teaching hospital in India, enrolled 290 postnatal mothers between 20 and 40 years who had vaginal delivery with < 2 on modified Oxford grading scale as measured by per vaginal digital examination. The subjects were randomized into experimental and control groups. The experimental group received instructions to perform Kegel's exercises along with routine postnatal care while the control group received advice on routine postnatal care. Two follow-up assessments were done at 6 and 10 weeks. The primary outcome measure was increase in Oxford grading score. Results Major findings of the study were: The mean perineal muscle strength assessment scores noted before the intervention and during first and second postintervention assessments were 1.5 ± 0.52, 3.58 ± 0.51 and 4.28 ± 0.57 respectively for the experimental group and 1.56 ± 0.55, 2.41 ± 0.52 and 3 ± 0.51 respectively for the control group. Comparison of these scores between the groups by unpaired t-test yielded p-value of < 0.0001 suggesting high significant difference in favor of the experimental group. However, no additional benefit was observed after Kegel's exercise in the mothers who had episiotomy during vaginal delivery. Conclusion The Kegel's exercise is effective to reduce perineal laxity and hence should be included as a part of routine postnatal care.

scholarly journals Effectiveness of structured teaching programme on knowledge about postnatal care among mothers

2017 ◽  
Vol 5 (11) ◽  
pp. 4993
Author(s):  
Neha Joshi ◽  
Gomathi B. ◽  
Kanchan Bala ◽  
Mahalingam V.
Keyword(s):  
Postnatal Care ◽  
Tertiary Care ◽  
Knowledge Score ◽  
Postnatal Period ◽  
Demographic Variables ◽  
Care Hospital ◽  
Post Test ◽  
Postnatal Mothers ◽  
Life Threatening ◽  
Structured Knowledge

Background: Mothers and new-borns are vulnerable to illness and deaths during the postnatal period. Care during postnatal period is the important part of maternal health care as the serious and life-threatening complications can occur in postnatal period.Methods: A Quantitative approach with pre- experimental design was used to study the effectiveness of STP on postnatal care. Sixty postnatal mothers were selected from tertiary care hospital. The Purposive sampling techniques was used to select the study subjects. Data was collected by using Structured Knowledge questionnaire.Results: The results show that the overall mean pre-test knowledge score of postnatal mothers was 19.8±2.98 and mean post-test knowledge score of postnatal mothers was 26.28±1.89 and the mean difference was 6.48. This revealed that the STP was an effective method in improving mother’s knowledge on postnatal care. There was no significant association found between pre-test knowledge score with their demographic variables except occupation.Conclusions: The findings of the study revealed that STP was effective in enhancing the knowledge of postnatal mothers on postnatal care.

scholarly journals Immediate postnatal care following childbirth in Ugandan health facilities: an analysis of Demographic and Health Surveys between 2001 and 2016

2021 ◽  
Vol 6 (4) ◽  
pp. e004230
Author(s):  
Teesta Dey ◽  
Sam Ononge ◽  
Andrew Weeks ◽  
Lenka Benova
Keyword(s):  
Postnatal Care ◽  
Health Surveys ◽  
Post Partum ◽  
Quality Care ◽  
Critical Time ◽  
Healthcare Facility ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Changes Over Time ◽  
Over Time

IntroductionProgress in reducing maternal and neonatal mortality, particularly in sub-Saharan Africa, is insufficient to achieve the Sustainable Developmental Goals by 2030. The first 24 hours following childbirth (immediate postnatal period), where the majority of morbidity and mortality occurs, is critical for mothers and babies. In Uganda,<50% of women reported receiving such care. This paper describes the coverage, changes over time and determinants of immediate postnatal care in Uganda after facility births between 2001 and 2016.MethodsWe analysed the 2006, 2011 and 2016 Ugandan Demographic and Health Surveys, including women 15–49 years with most recent live birth in a healthcare facility during the survey 5-year recall period. Immediate postnatal care coverage and changes over time were presented descriptively. Multivariable logistic regression was used to examine determinants of immediate postnatal care.ResultsData from 12 872 mothers were analysed. Between 2006 and 2016, births in healthcare facilities increased from 44.6% (95% CI: 41.9% to 47.3%) to 75.2% (95% CI: 73.4% to 77.0%) and coverage of immediate maternal postnatal care from 35.7% (95% CI 33.4% to 38.1%) to 65.0% (95% CI: 63.2% to 66.7%). The majority of first checks occurred between 1 and 4 hours post partum; the median time reduced from 4 hours to 1 hour. The most important factor associated with receipt of immediate postnatal care was women having a caesarean section birth adjusted OR (aOR) 2.93 (95% CI: 2.28 to 3.75). Other significant factors included exposure to mass media aOR 1.38 (95% CI: 1.15 to 1.65), baby being weighed at birth aOR 1.84 (95% CI: 1.58 to 2.14) and receipt of antenatal care with 4+Antenatal visits aOR 2.34 (95% CI: 1.50 to 3.64).ConclusionIn Uganda, a large gap in coverage remains and universal immediate postnatal care has not materialised through increasing facility-based births or longer length of stay. To ensure universal coverage of high-quality care during this critical time, we recommend that maternal and newborn services should be integrated and actively involve mothers and their partners.

scholarly journals Knowledge on postnatal care among postpartum mothers during discharge in maternity hospitals in Asmara: a cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ghirmay Ghebreigziabher Beraki ◽  
Eyasu H. Tesfamariam ◽  
Amanuel Gebremichael ◽  
Berhanemeskel Yohannes ◽  
Kessete Haile ◽  
...  
Keyword(s):  
Breast Feeding ◽  
Educational Level ◽  
Postnatal Care ◽  
Knowledge Score ◽  
Cross Sectional Study ◽  
Postnatal Period ◽  
Danger Sign ◽  
Cross Sectional ◽  
Maternity Hospitals ◽  
Postpartum Mothers

Abstract Background The early postnatal period is a dangerous time for both mother and baby where morbidity and mortality are highly prevalent if proper care is not done. Post natal care (PNC) knowledge has significant role in reducing such complications. In this study, the knowledge of postpartum mothers on PNC and its determinants were determined. Methods A cross-sectional quantitative study was conducted in postpartum mothers (PpM) who attended all maternal delivery services in Asmara. Data was collected by a structured questionnaire. All (n = 250) PpM who gave birth in December, 2017 were included in the study. Independent samples t-test and one way ANOVA were used to compare the scores in knowledge across categories of background characteristics using SPSS. Bonferroni post-hoc test was performed for variables that were found to be significant while using ANOVA tool. P-values less than 0.05 were considered as significant. Results The percentage of PpM who cited vaginal bleeding, as a maternal danger sign, and fever, as a baby danger sign, were 83.2 and 58.8%, respectively. The majority (96%) of PpM responded the correct answer on where to go if they note any danger signs. In addition, more than nine tenth of PpM correctly identified injectable contraceptives (92.7%) and oral contraceptive (91.5%). The percentages of knowledge in recognizing the necessary nutrients ranged from 87.6% for carbohydrates to 46% for minerals. The percentages of correct knowledge regarding first baby bath, frequency of breast feeding, umbilical care, duration of exclusive breast feeding, need and purpose of vaccine were 40.1, 81.9, 77.4, 94.8, and 99.2% respectively. The mean PNC knowledge score was 24.89/60. The score of knowledge on postnatal care was found to significantly differ across the categories of residence (p < 0.001) and ethnicity (p = 0.015). An increasing trend of knowledge score was observed with increase in age group (p < 0.001), educational level (p = 0.021), gravida (p < 0.001) and para (p < 0.001). Conclusion Considerable gaps in knowledge regarding postnatal care among postpartum mothers were evident. Special attention should be laid on rural residents, single/living together, junior/below in educational level, primigravida/para, non-Tigrigna ethnicity, and 17 to 25 years old mothers.

scholarly journals Early discharge and rehabilitation in paediatric acquired brain and neurological injury: a transferable model

2018 ◽  
pp. edpract-2018-315096
Author(s):  
Rachel Keetley ◽  
Laura Kelly ◽  
William P Whitehouse ◽  
Sophie Thomas ◽  
Emily Bennett ◽  
...  
Keyword(s):  
Discharge Planning ◽  
Quality Care ◽  
Acquired Brain Injury ◽  
Early Discharge ◽  
Family Satisfaction ◽  
Neurological Injury ◽  
Children And Young People ◽  
Financial Gain ◽  
Lengths Of Stay ◽  
Improve Patient

Children and young people who require rehabilitation following sustaining an acquired brain injury often experience long lengths of stay (LOS) and potentially poorer recovery outcomes due to limited access to therapy and little proactive discharge planning. After stakeholder enquiry we launched a new team and pathway with a primary aim to reduce LOS. The secondary aims were to pilot an outreach model, reduce cost and improve patient and family satisfaction. We achieved a significantly improved change in quality care with a financial gain and increased patient and family satisfaction.

scholarly journals Women’s postnatal care based on the Polish and international recommendations

2018 ◽  
Vol 17 (3) ◽  
pp. 65-68
Author(s):  
Agnieszka Czerwińska-Osipiak ◽  
Beata Pięta ◽  
Justyna Kamińska ◽  
Halina Nowakowska
Keyword(s):  
Professional Practice ◽  
Postpartum Period ◽  
Postnatal Care ◽  
Perinatal Care ◽  
World Health Organisation ◽  
Postnatal Period ◽  
World Health ◽  
Care Providers ◽  
Risk Pregnancy

Abstract Introduction. The issue of high-risk pregnancy has been widely discussed in the recent years. As a result, many countries have introduced programs to improve perinatal care in order to meet the needs of pregnant women as well as those going into labour. Much less attention was dedicated to health and social circumstances of women in the postpartum period. The World Health Organisation developed a document (WHO Recommendations on Postnatal Care of the Mother and Newborn, 2013) in which it clearly defines recommendations formulated for the professionals who are care providers to the child and the mother after birth. The authors of the report indicate that the postnatal period is crucial for both the mothers and their children, and the lack of proper care given to them may lead to deterioration of their health and even death. According to the code of professional practice, the Polish midwife identifies and determines individuals’ requirements as well as health needs, recognizes nursing difficulties, and, effectively plans and oversees their care. The Polish guideline for the highest standard of medical care during pregnancy, the delivery, the postpartum period and the neonatal care is the Regulation of the Health Minister from 20th September 2012. Aim. This paper collected current and adopted recommendations regarding postpartum care with an emphasis on the significant role of the midwife.

scholarly journals Effectiveness Of Topical Application Of Chlorhexidine And Prevailing Practices On Episiotomy Wound Among Postnatal Mothers

2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Rincy Michael ◽  
Soney N Toppo ◽  
Varsha Hariharan
Keyword(s):  
Wound Healing ◽  
Topical Application ◽  
Controlled Trial ◽  
Demographic Data ◽  
Assessment Scale ◽  
Research Centre ◽  
Control Group ◽  
Significant Difference ◽  
Postnatal Mothers ◽  
Experimental Group

Puerperium is a period when the mother experiences intense physical and emotional stress due to exhaustion, anxiety and excitement. Each mother has to adjust to physical changes in her own body due to involution and lactation as well as cope up with the new demands on her time and emotions made by the new born baby. Episiotomy, despite evidences that it is an unnecessary intervention, is one of the most common surgical procedures performed during the second stage of labour, especially in primigravida woman. Thus, a randomized controlled trial to assess the effectiveness of topical application of chlorhexidine and prevailing practices on episiotomy wound among postnatal mothers at selected hospital of Indore was undertaken. True experimental approach with pre test post test research design was adopted. Simple random sampling was taken to select 40 postnatal mothers with episiotomy wound and three days postpartum hospital stay in Choithram Hospital & Research Centre, Indore as per the inclusion criteria. Data was collected with help of questionnaire for socio demographic data and obstetrical data and the wound healing was assessed by REEDA wound healing assessment scale. Samples in the experimental group were applied with chlorhexidine on episiotomy wound and the samples in the control group received routine care with betadine or nadoxin. Post assessment score was taken on third day (evening) by REEDA wound assessment scale. Finding of the study related to effectiveness of chlorhexidine among postnatal mothers in experimental group revealed that there was a significant difference in the healing of episiotomy wound by the application of chlorhexidine among postnatal mothers in experimental group at t19 = 11.40 at the level of p< 0.001. Hence it was inferred that topical application of chlorhexidine on episiotomy wound promotes wound healing.

scholarly journals An assessment of utilization of postnatal care services in urban area Jabalpur district

2019 ◽  
Vol 6 (9) ◽  
pp. 3660
Author(s):  
Dhruvendra Pandey ◽  
Priyanka Meshram ◽  
Arvind Sharma ◽  
Rajesh Tiwari ◽  
P. K. Kasar
Keyword(s):  
Urban Area ◽  
Urban Areas ◽  
Postnatal Care ◽  
Sampling Method ◽  
Mode Of Delivery ◽  
Great Majority ◽  
Cross Sectional Study ◽  
Postnatal Period ◽  
Cross Sectional ◽  
Early Registration

Background: Postnatal period is a vulnerable time, because most maternal and new born deaths occur during this period, especially immediately after childbirth. Postnatal care in the first hours and days after childbirth could prevent the great majority of these deaths. The objective of study was to assess the utilization of post-natal care and associated factors for low utilization in urban area of Jabalpur district.Methods: A community based cross-sectional study was carried 360 mothers who delivered in last one year in urban area of Jabalpur district. Sampling method was multistage sampling method. A total 36 wards with 10 mothers from each ward was selected. The questionnaire included information related to mode of delivery, post-natal checkups and visits of health care providers.Results: Among 360 mothers, 93.9% mothers received first postnatal check-up within 24 hrs. 1.11% of mothers between 2-3 days and 1.67% of mothers received first postnatal check-up between 4-7 days while 3.33% of mothers didn’t receive any postnatal check-up. Regarding number of post-natal visits, 58.33% mothers received 3 or more postnatal visits, 35% of mother received 2 PNC visits, while 3.3% did not receive a single postnatal visit. The education of mothers, joint type of family, high socioeconomic status, early registration of pregnancy, minimum 4 ANC visits and institutional deliveries were found significantly associated with utilization of postnatal check-up.Conclusions: Utilization of postnatal services is still poor in the urban areas even though the physical accessibility was adequate. In the present study, it was concluded that the role of education, especially of female education, is important contributing factor associated with utilization of postnatal care.

PP20 UK Ambulance Service resuscitation management of pulseless electrical activity: a systematic review of text and opinion

2021 ◽  
Vol 38 (9) ◽  
pp. A9.2-A9
Author(s):  
Ali Coppola ◽  
Michael A Smyth ◽  
Sasha Johnston ◽  
Sarah Black ◽  
Ruth Endacott
Keyword(s):  
Electrical Activity ◽  
Early Identification ◽  
Discharge Rate ◽  
Treatment Options ◽  
Pulseless Electrical Activity ◽  
Ambulance Service ◽  
National Guidelines ◽  
Improve Patient Survival ◽  
The United Kingdom ◽  
Improve Patient

BackgroundIn the United Kingdom, out of hospital cardiac arrest patients with pulseless electrical activity (PEA) have a poor survival to discharge rate of 5.3%.1 PEA is managed according to national guidelines.2 These guidelines are imperfect due to limited research resulting in ambulance services locally amending guidelines to support resuscitation decisions.3 This review aimed to examine the local guidelines of UK ambulance services for the management of PEA.MethodsA three-step search strategy was applied from August 2020 to October 2020. 1) A search of UK ambulance service websites was conducted to identify published local guidelines. Where guidelines were not available a written request was made for the guideline, associated guideline or a narrative summary in the absence of a guideline. 2) Documents referenced within the local guidelines specific to pulseless electrical activity were identified and extracted as supporting literature. 3) Documents referenced in the supporting literature identified as having pulseless electrical activity in the title were extracted.ResultsTwenty-two documents of textual data met the inclusion criteria. Twenty-nine conclusions were extracted and analysed to generate ten categories, forming three synthesised themes relating to the variability in the clinical management of PEA between UK ambulance services, the early identification of reversible causes and appropriate treatment options to increase survivability and the consensus for further research.ConclusionComprehensive national guidelines are lacking due to limited research. The local clinical guidelines and practices of UK ambulance services which aim to address the gaps in research, introduce variability in the management of pulseless electrical activity. Early identification and treatment to reverse the cause of pulseless electrical activity was highlighted to improve patient survival, however, this was complex and challenging to achieve during pre-hospital resuscitation. There was a consensus in the paucity of evidence and the potential for future prognostic research to improve patient outcomes.

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